Individual
DR. MARK PHILLIP VANDER HORCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1130 LAKE PLAZA DR, SUITE #230, COLORADO SPRINGS, CO 80906
(719) 219-3819
(719) 219-0411
Mailing address
1130 LAKE PLAZA DR, SUITE #230, COLORADO SPRINGS, CO 80906
(719) 219-3819
(719) 219-0411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1049
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08010496
—
CO
Enumeration date
08/31/2006
Last updated
11/17/2009
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