Individual
MR. RAYMOND F WENCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
2866 TAMIAMI TRL, SUITE D, PORT CHARLOTTE, FL 33952-5126
(941) 255-0038
(941) 255-0728
Mailing address
2510 E SUNSET RD, UNIT 5-260, LAS VEGAS, NV 89120-3511
(702) 798-0113
(866) 291-5242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AS2799
FL
Other
Enumeration date
11/17/2006
Last updated
12/16/2014
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