Individual
VICKIE L VANDERLAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 LEAHY ST, STE 109, MUSKEGON, MI 49442-5500
(231) 728-5720
(231) 728-5721
Mailing address
1675 LEAHY ST, STE 109, MUSKEGON, MI 49442-5500
(231) 728-5720
(231) 728-5721
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
1601000084
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540F111730
BCBS SUPPLIER ID
MI
01
—
640F12603
BCBS AUDIO ID
MI
05
—
904900723
—
MI
Enumeration date
09/27/2006
Last updated
05/01/2014
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