Provider Demographics
NPI:1184028573
Name:VALLEY ALLERGY AND ASTHMA CLINIC, LLC
Entity Type:Organization
Organization Name:VALLEY ALLERGY AND ASTHMA CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALLERGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSENEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-322-6070
Mailing Address - Street 1:425 E DAHLIA AVE
Mailing Address - Street 2:SUITE MB
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6463
Mailing Address - Country:US
Mailing Address - Phone:518-322-6070
Mailing Address - Fax:
Practice Address - Street 1:425 E DAHLIA AVE
Practice Address - Street 2:SUITE MB
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6463
Practice Address - Country:US
Practice Address - Phone:518-322-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7841261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty