Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CPO 1530 |
NPI | 1477612760 |
---|---|
Provider Name | Mr. Gregory Michael Vanhoof |
First Address | Brookfield, CT 06804 |
Second Address | Brookfield, CT 06804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |