Healthcare Provider Details

I. General information

NPI: 1154594349
Provider Name (Legal Business Name): VALLEY ORTHOPEDIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5603 W HILLSDALE AVE
VISALIA CA
93291-5136
US

IV. Provider business mailing address

5603 W HILLSDALE AVE
VISALIA CA
93291-5136
US

V. Phone/Fax

Practice location:
  • Phone: 559-733-7976
  • Fax: 559-733-3836
Mailing address:
  • Phone: 559-733-7976
  • Fax: 559-733-3836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: SHERYL PRICE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288