Provider Demographics
NPI:1457108680
Name:WASNESKI, JOSEPH FRANCIS VILLANUEVA (NMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH FRANCIS
Middle Name:VILLANUEVA
Last Name:WASNESKI
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 S BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4528
Mailing Address - Country:US
Mailing Address - Phone:480-385-9060
Mailing Address - Fax:
Practice Address - Street 1:804 S BRADLEY DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4528
Practice Address - Country:US
Practice Address - Phone:480-385-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24-1861175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath