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General NPI Number Information
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NPI Number | 1144533753
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Entity Type | Organization
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Legal Business Name | DR VANDERPLOEG & ASSOCIATES INC
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 7397 MAIN ST STE I
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City | NEWTOWN
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State | OH
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Zip | 45244-3034
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Country | US
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Telephone | 513-991-7090
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Fax | 513-991-7091
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Provider Business Mailing Address
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Address Line | 7397 MAIN ST STE I
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City | NEWTOWN
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State | OH
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Zip | 45244-3034
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Country | US
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Telephone | 513-991-7090
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Fax | 513-991-7091
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN VANDERPLOEG
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Credential | O.D.
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Telephone | 513-991-7090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5983
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License Number State | OH
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