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Individual

MR. JOSHUA K ENEVOLDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
431 N 21ST ST, CAMP HILL, PA 17011
(717) 763-3730
(717) 763-3734
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5149
AZ
363A00000X
Physician Assistant
Primary
MA060552
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
707901
AZ
Enumeration date
06/08/2012
Last updated
08/28/2020
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