JASON R VANDEVENTER

BLOOMINGTON, IN
NPI1205831070
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IN  05007082A)
Enumeration Date2005-06-16
Last Update Date2008-09-26
Business Address
-- JASON R VANDEVENTER MPT
719 S ROGERS ST
BLOOMINGTON, IN 47403-2335
Phone number: 812-323-4475
Mailing Address
-- JASON R VANDEVENTER MPT
550 S LANDMARK AVE
BLOOMINGTON, IN 47403-3239
Phone number: 812-323-4475
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