Individual
DR. RICHARD VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6960 SW 39TH ST, #102, DAVIE, FL 33314-2411
(954) 609-7015
Mailing address
6960 SW 39TH ST, #102, DAVIE, FL 33314-2411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4689
FL
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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