MEDICARE: TERRY VALENTINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225000000X	Orthotic Fitter

General Provider Information

NPI Number	:	1225207822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY VALENTINE

Provider Business Mailing Address
First Line	:	7110 WURZBACH RD
Second Line	:	APT 403
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4821
Country	:	US
Telephone Number	:	210-330-6799
Fax Number	:

Provider Business Practice Location Address
First Line	:	7110 WURZBACH RD
Second Line	:	APT 403
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4821
Country	:	US
Telephone Number	:	210-330-6799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	02/27/2008

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Directions to “ TERRY VALENTINE ” Practice Location

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