Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4282 | SC |
NPI | 1073021143 |
---|---|
Provider Name | Dr. Yamira Valentin-Fuentes |
First Address | Spartanburg, SC 29301 |
Second Address | Spartanburg, SC 29301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2018 |
Last Update Date | 11/01/2018 |