Provider Demographics
NPI:1811168479
Name:DR. VANVRANKEN & ASSOCIATES
Entity type:Organization
Organization Name:DR. VANVRANKEN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/HYGIENIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAVENA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:PEAVYHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:CDA, RDH, MPH
Authorized Official - Phone:931-454-0001
Mailing Address - Street 1:1958 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2204
Mailing Address - Country:US
Mailing Address - Phone:931-454-0001
Mailing Address - Fax:931-454-0973
Practice Address - Street 1:1958 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2204
Practice Address - Country:US
Practice Address - Phone:931-454-0001
Practice Address - Fax:931-454-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental