Individual
DANIEL RAY VREDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 LATTICE DR, STEPHENSON, VA 22656-1889
(303) 931-8521
Mailing address
100 LATTICE DR, STEPHENSON, VA 22656-1889
(303) 931-8521
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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