Provider Demographics
NPI:1457033201
Name:SAVALLE, JOEL ADAM
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ADAM
Last Name:SAVALLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14390 BARBARA ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5349
Mailing Address - Country:US
Mailing Address - Phone:734-718-3659
Mailing Address - Fax:
Practice Address - Street 1:14390 BARBARA ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5349
Practice Address - Country:US
Practice Address - Phone:734-718-3659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.506737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse