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General NPI Number Information
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NPI Number | 1811526296
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Entity Type | Individual
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Provider Name | ERIC VANDONGEN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 2004 HAYES ST STE 110
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City | NASHVILLE
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State | TN
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Zip | 37203-2648
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Country | US
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Telephone | 615-815-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 210 STOCKYARD ST APT 201
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City | NASHVILLE
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State | TN
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Zip | 37201-1136
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Country | US
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Telephone | 908-304-8043
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12679
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01685000
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License Number State | NJ
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