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Individual
MARC LEE VANDERVELDEN
Active
Individual
MARC LEE VANDERVELDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03548
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37197
IND
IA
01
—
37198
BCBS GR & MADRID
IA
01
—
39199
BCBS AH
IA
Enumeration date
05/03/2006
Last updated
08/07/2012
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