Clay Vandenberg, OTA

NPI #1679065411 in Saint Augustine, Florida

Provider Information

NPI Number: 1679065411
Entity Type: Individual
Name: Clay Vandenberg, OTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Orthopaedic Surgery
Credential: OTA
Enumeration Date: Jun 6, 2018
Last Updated: Jun 6, 2018

Practice Location

Address: 1 ORTHOPAEDIC PL
City: Saint Augustine
State: Florida
ZIP Code: 32086-4202
Phone: (904) 825-0540

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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