Individual
BRYCE WADE VANDEVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOT, OTR
Contact information
Practice address
3602 E GREENWAY RD STE 102, PHOENIX, AZ 85032-4648
(602) 560-2832
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
26334
CA
225X00000X
Occupational Therapist
OTH-008318
AZ
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
11/30/2020
Last updated
04/25/2026
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