Individual
MICHAEL VANDERHOOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN05/23/1946
Contact information
Practice address
608 COLLEGE HWY, SOUTHWICK, MA 01077-9579
(413) 569-6446
(413) 569-0890
Mailing address
608 COLLEGE HWY, SOUTHWICK, MA 01077-9579
(413) 569-6446
(413) 569-0890
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1951
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519816
—
MA
Enumeration date
09/12/2006
Last updated
07/08/2007
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