Individual
VERNON VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
720 BROADWAY ST APT 9, WILLIAMSBURG, NM 87942
(210) 544-4857
Mailing address
3530 FOOTHILLS RD, STE N, LAS CRUCES, NM 88011-3621
(575) 532-6054
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4949
NM
Other
Enumeration date
02/07/2017
Last updated
03/08/2018
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