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General NPI Number Information
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NPI Number | 1821666967
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Entity Type | Organization
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Legal Business Name | VANDEMAN VISION HEALTH
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 9801 GEORGIA AVE STE 339
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City | SILVER SPRING
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State | MD
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Zip | 20902-5276
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Country | US
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Telephone | 240-863-2822
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Fax |
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Provider Business Mailing Address
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Address Line | 4703 CHEROKEE ST
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City | COLLEGE PARK
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State | MD
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Zip | 20740-1816
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Country | US
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Telephone | 301-455-1348
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. TIMOTHY VANDEMAN
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Credential |
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Telephone | 301-455-1348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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