Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 4084 | TX |
Y | 111NS0005X | Chiropractic Sports Physician | DC-003905R | PA |
NPI | 1124273982 |
---|---|
Provider Name | Dr. Valentine Guzman |
First Address | Folsom, PA 19033-3310 |
Second Address | Folsom, PA 19033-3310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2008 |
Last Update Date | 26/03/2010 |