Individual
ERIC DAVID VANFOSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1205 FAIRINGTON DR, SIDNEY, OH 45365-8144
(937) 492-8431
Mailing address
21039 GEYER DR, WAPAKONETA, OH 45895-8815
(937) 596-5386
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0805
OH
Other
Enumeration date
02/07/2007
Last updated
12/02/2020
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