Individual
RICHARD VERVOORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
H.I.S.
Contact information
Practice address
550 N MILITARY AVE, GREEN BAY, WI 54303-4569
(920) 497-4600
Mailing address
140 CORPORATE DR, SUITE 1, BEAVER DAM, WI 53916-1281
(920) 887-9655
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1264-060
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42839000
—
WI
Enumeration date
10/09/2007
Last updated
10/09/2007
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