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General NPI Number Information
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NPI Number | 1487646816
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Entity Type | Individual
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Provider Name | PHILIP W VALENTINE OD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 739 SPRUCE AVE
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City | SIDNEY
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State | OH
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Zip | 45365-0179
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Country | US
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Telephone | 937-492-1990
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Fax | 937-492-7230
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Provider Business Mailing Address
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Address Line | PO BOX 179
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City | SIDNEY
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State | OH
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Zip | 45365-0179
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Country | US
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Telephone | 937-492-1990
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Fax | 937-492-7230
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2815T1994
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License Number State | OH
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