Individual
HEATHER LYNN VANDERSLOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2861 STATE HIGHWAY 7, OTEGO, NY 13825-2139
(607) 353-2183
Mailing address
2861 STATE HIGHWAY 7, OTEGO, NY 13825-2139
(607) 353-2183
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
474038769
NY
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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