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General NPI Number Information
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NPI Number | 1285388538
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Entity Type | Individual
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Provider Name | RYAN PLACIDO VALENCIANO DPT
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Gender | Male
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 474 LAUKAPU ST STE 2
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City | HILO
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State | HI
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Zip | 96720-4477
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Country | US
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Telephone | 808-339-7478
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Fax | 808-657-4980
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Provider Business Mailing Address
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Address Line | PO BOX 5718
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City | KALISPELL
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State | MT
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Zip | 59903-5718
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Country | US
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Telephone | 406-756-0134
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Fax | 406-309-2579
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0017959
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-5915-0
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License Number State | HI
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