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Charles Vandervort, O.D
NPI 1629047758 · on the registry since 2006 · sole proprietor
Practice
- Address
- 665 Uinta Dr
Green River, WY 82935 - Phone
- (307) 875-4538
- Fax
- (307) 875-8997
- Organisation at this address
- Charles R. Vandervort, O.D., P.C.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- WY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-09-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming