Individual
WAYNE VANDERLEEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
823 FRANKLIN ST, PELLA, IA 50219-1603
(641) 628-9225
(641) 628-8698
Mailing address
823 FRANKLIN ST, PELLA, IA 50219-1603
(641) 628-9225
(641) 628-8698
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1682
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160770
—
IA
Enumeration date
01/06/2006
Last updated
12/12/2012
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