Individual
JOSHUA ERIC KWASNICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 MEMORIAL DR STE 502, SOUTH BEND, IN 46601-1075
(574) 647-5875
Mailing address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 475-7344
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
10003694A
IN
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/29/2016
Last updated
05/22/2024
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