| Doctor Name: | JOSHUA JOHN YANZER |
| NPI Number: | 1164886628 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | W307s8579 Woodland Dr Mukwonago, WI - 531498821 |
| Business Phone Number: | 2623138991 |
| Business Fax Number: | |
| Mailing Address: | W307s8579 Woodland Dr, MUKWONAGO |
| State: | WI |
| Postal Code: | 531498821 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2016 |
| NPI Last Update Date: | 04/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |