Individual
DR. JEREMY JENSEN VANDULUITGAARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6000 BROCKTON DR, LOCKPORT, NY 14094-9273
(716) 282-2888
Mailing address
4503 STONEY BROOK RD, ONEIDA, NY 13421-3715
(315) 762-3533
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
047585
NY
Other
Enumeration date
10/30/2021
Last updated
10/30/2021
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