Organization
CHARLES R. VANDERVORT, O.D., P.C.
Active
Other names
EYE CARE SPECIALISTS OF GREEN RIVER
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES R VANDERVORT O.D. (PRESIDENT)
(307) 875-4538
Entity
Organization
Contact information
Practice address
665 UINTA DR, GREEN RIVER, WY 82935-5031
(307) 875-4538
(307) 875-8997
Mailing address
665 UINTA DR, GREEN RIVER, WY 82935-5031
(307) 875-4538
(307) 875-8997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
101T
WY
Other
Enumeration date
12/14/2008
Last updated
08/11/2010
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