Individual
MR. CARL JASON ANTONIL VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1839 ONSLOW DR, JACKSONVILLE, NC 28540-5906
(910) 455-3610
Mailing address
2015 HUNTERS RIDGE DR, MIDWAY PARK, NC 28544-1635
(910) 577-1210
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8040
NC
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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