Provider Demographics
NPI:1457376337
Name:HUDEC, JOANNA KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:KAY
Last Name:HUDEC
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 1:332 W WREN CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5317
Mailing Address - Country:US
Mailing Address - Phone:479-587-9448
Mailing Address - Fax:
Practice Address - Street 1:125 E TOWNSHIP ST
Practice Address - Street 2:SUITE 10
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2817
Practice Address - Country:US
Practice Address - Phone:479-587-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor