Provider Demographics
NPI:1477198307
Name:CHRISTOPHER J VANDELUNE DO PC
Entity Type:Organization
Organization Name:CHRISTOPHER J VANDELUNE DO PC
Other - Org Name:SIOUX VALLEY FAMILY HEALTH PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDELUNE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:712-225-9003
Mailing Address - Street 1:115 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012-1814
Mailing Address - Country:US
Mailing Address - Phone:712-225-9003
Mailing Address - Fax:712-225-9004
Practice Address - Street 1:115 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1814
Practice Address - Country:US
Practice Address - Phone:712-225-9003
Practice Address - Fax:712-225-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care