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NPI 1699785097

NPI 1699785097 : MATTHEW ANTHONY VALENTINO P.T. : GILBERT, AZ

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General NPI Number Information
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    NPI Number           |    1699785097
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    Entity Type          |    Individual 
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    Provider Name        |    MATTHEW ANTHONY VALENTINO P.T.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/08/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3303 S LINDSAY RD SUITE #116
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    City                 |    GILBERT
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    State                |    AZ
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    Zip                  |    85296-6503
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    Country              |    US
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    Telephone            |    480-782-9696
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1370 S WESTERN SKIES DR 
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    City                 |    GILBERT
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    State                |    AZ
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    Zip                  |    85296-4335
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    Country              |    US
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    Telephone            |    480-610-8666
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    Fax                  |    
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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       |    4401
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    License Number State |    AZ
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