Individual
MRS. ANTOINETTE MARIE VANDERLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L.
Contact information
Practice address
4263 PETERBORO ST, VERNON, NY 13476-3612
(315) 829-3283
Mailing address
4263 PETERBORO ST, VERNON, NY 13476-3612
(315) 829-3283
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
010330-1
NY
Other
Enumeration date
09/29/2010
Last updated
09/30/2010
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