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General NPI Number Information
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NPI Number | 1710091079
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Entity Type | Individual
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Provider Name | DAVID S. VANDERLINDE O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 1180 M-32 WEST
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City | ALPENA
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State | MI
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Zip | 49707
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Country | US
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Telephone | 989-354-7431
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Fax | 989-354-7532
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Provider Business Mailing Address
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Address Line | 4470 N LAKE SHORE DR
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City | BLACK RIVER
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State | MI
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Zip | 48721-9775
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Country | US
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Telephone | 989-724-7902
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901002833
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License Number State | MI
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