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General NPI Number Information
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NPI Number | 1750330312
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Entity Type | Individual
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Provider Name | VALDON GALE LANDES DO
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 1175 58TH AVE STE 202
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City | GREELEY
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State | CO
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Zip | 80634-4807
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Country | US
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Telephone | 970-495-0300
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Fax | 970-224-9624
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Provider Business Mailing Address
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Address Line | 1175 58TH AVE STE 202
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City | GREELEY
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State | CO
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Zip | 80634-4807
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Country | US
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Telephone | 970-495-0300
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Fax | 970-224-9624
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 41081
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License Number State | CO
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