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Individual

MR. JONATHAN J VANTUYL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC

Contact information

Practice address
1802 S SAINT AUBIN ST APT C, SIOUX CITY, IA 51106-2503
(712) 535-4499
Mailing address
1802 S SAINT AUBIN ST APT C, SIOUX CITY, IA 51106-2503
(712) 535-4499

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20044
IA

Other

Enumeration date
04/27/2021
Last updated
04/27/2021
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