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1790101186
ALEX VANDEUSEN
TERRE HAUTE, IN
NPI
1790101186
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36002010A)
Enumeration Date
2014-03-10
Last Update Date
2017-02-14
Business Address
-- ALEX VANDEUSEN
1606 N 7TH ST
TERRE HAUTE, IN 47804-2706
Phone number: 812-238-7000
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Mailing Address
-- ALEX VANDEUSEN
4300 OLD PARIS RD APT. P
WEST TERRE HAUTE, IN 47885-9025
Phone number: 607-435-8959
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