Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1053077743 |
---|---|
Provider Name | Joseph Adam Wenzel |
First Address | Whitehall, OH 43213-3028 |
Second Address | Whitehall, OH 43213-2950 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2021 |
Last Update Date | 16/11/2021 |