Individual
DR. BRIAN STEPHEN VANDERHOOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2400 WISTERIA DR, SUITE A, SNELLVILLE, GA 30078-2689
(770) 985-9330
(770) 978-9455
Mailing address
2400 WISTERIA DR, SUITE A, SNELLVILLE, GA 30078-2689
(770) 985-9330
(770) 978-9455
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
038391
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00665695A
—
GA
Enumeration date
02/12/2007
Last updated
07/08/2007
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