Individual
MR. BRYAN VANDEHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1226 BERLIN ST, WAUPACA, WI 54981-1991
(715) 258-5521
Mailing address
761 POWERS ST, OSHKOSH, WI 54901-4656
(920) 216-8854
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1791-19
WI
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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