Provider Demographics
NPI:1306437330
Name:VANDEHEI, ABIGAIL (DC)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:
Last Name:VANDEHEI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 SILVERSIDE RD BLDG STE 102
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4812
Mailing Address - Country:US
Mailing Address - Phone:302-477-1565
Mailing Address - Fax:
Practice Address - Street 1:3411 SILVERSIDE RD BLDG STE 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-477-1565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0011036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor