Individual
DR. LARRY H VANDAALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
108 2ND ST NW, WAVERLY, IA 50677-2619
(319) 559-2020
(319) 559-2021
Mailing address
108 2ND ST NW, WAVERLY, IA 50677-2619
(319) 559-2020
(319) 559-2021
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1865
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2253799
—
IA
01
—
46986
BCBS
IA
Enumeration date
07/07/2006
Last updated
10/05/2016
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