Individual
DR. JONATHAN CHRISTIAN VANDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8805
(616) 840-9642
Mailing address
1331 MOURSUND AVENUE, BLDG. G RM 115-118, HOUSTON, TX 77030-5389
(713) 799-5033
(713) 797-5982
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
125.066293
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101025744
MI
Other
Enumeration date
06/30/2015
Last updated
03/31/2021
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