Individual
BRITTANY VANDER KOOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 CONCOURS ST BLDG 6 SUITE 100, ONTARIO, CA 91764-2347
(909) 481-3242
Mailing address
11511 MAGNOLIA AVE UNIT 406, RIVERSIDE, CA 92505-4889
(949) 939-7997
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95012582
CA
Other
Enumeration date
03/10/2020
Last updated
10/03/2021
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