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1487850558
RUSSELL ALLEN VANDE VEGTE
SAN DIEGO, CA
NPI
1487850558
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: CA 14066)
Enumeration Date
2007-06-25
Last Update Date
2021-11-19
Business Address
Mr. RUSSELL ALLEN VANDE VEGTE PT
4510 VIEWRIDGE AVE
SAN DIEGO, CA 92123-1637
Phone number: 858-694-4922
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Mailing Address
Mr. RUSSELL ALLEN VANDE VEGTE PT
2509 ARNOTT ST
SAN DIEGO, CA 92110-1152
Phone number: 619-276-7980
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