Provider Demographics
NPI:1447827738
Name:VAN VEEN & ASSOCIATES
Entity type:Organization
Organization Name:VAN VEEN & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:P
Authorized Official - Last Name:VAN VEEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:864-316-9053
Mailing Address - Street 1:5823 CALHOUN MEMORIAL HWY STE 2A
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3874
Mailing Address - Country:US
Mailing Address - Phone:864-855-6571
Mailing Address - Fax:
Practice Address - Street 1:5823 CALHOUN MEMORIAL HWY STE 2A
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3874
Practice Address - Country:US
Practice Address - Phone:864-855-6571
Practice Address - Fax:864-855-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty