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Individual

CLAY VANDENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
1 ORTHOPAEDIC PL, SAINT AUGUSTINE, FL 32086-4202
(904) 825-0540
Mailing address
1756 S CLYDE MORRIS BLVD APT 1008, DAYTONA BEACH, FL 32119-9035
(973) 800-4220

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1770020919
FL

Other

Enumeration date
06/06/2018
Last updated
06/06/2018
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