Individual
JOSEPH BENJAMIN VANDAVEER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, NCS
Contact information
Practice address
301 E CHEROKEE ST, LINDSAY, OK 73052
(405) 756-4303
Mailing address
301 E CHEROKEE ST, LINDSAY, OK 73052-4414
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
4228
OK
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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