Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 310 | NV |
NPI | 1003030230 |
---|---|
Provider Name | Dr. Joseph Peter Wadoski |
First Address | Las Vegas, NV 89121-7330 |
Second Address | Las Vegas, NV 89121-7330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |