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Individual

RAYMOND P VANDENHOVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112

Taxonomy

Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
DR.0024297
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01242973
CO
05
109130100
WY
01
250005420
RR MEDICARE
CO
Enumeration date
11/21/2005
Last updated
12/16/2019
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