Individual
JOSE VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
101 MED TECH PKWY, SUITE 200, JOHNSON CITY, TN 37604-4007
(423) 232-6120
Mailing address
101 MED TECH PKWY, SUITE 200, JOHNSON CITY, TN 37604-4007
(423) 232-6120
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
000002402
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089600
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/27/2006
Last updated
07/08/2007
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