Individual
KEVIN RICK VANDERHOEF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1020 BIG A RD, TOCCOA, GA 30577-6010
(706) 886-0111
(706) 886-7680
Mailing address
1020 BIG A RD, TOCCOA, GA 30577-6010
(706) 886-0111
(706) 886-7680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001577
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000743003D
—
GA
Enumeration date
10/26/2005
Last updated
12/04/2013
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