Provider Demographics
NPI:1528657715
Name:VAN NESS, JOSHUA VAN NESS (HAS)
Entity type:Individual
Prefix:MR
First Name:JOSHUA VAN
Middle Name:NESS
Last Name:VAN NESS
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 RENEE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4372
Mailing Address - Country:US
Mailing Address - Phone:843-903-0635
Mailing Address - Fax:843-903-0636
Practice Address - Street 1:3885 RENEE DR STE 102
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4372
Practice Address - Country:US
Practice Address - Phone:843-903-0635
Practice Address - Fax:843-903-0636
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS-0635237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist