Provider Demographics
NPI:1225111065
Name:VALLEE, CHARLES PHILLIP (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PHILLIP
Last Name:VALLEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 THE ORCH
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2816
Mailing Address - Country:US
Mailing Address - Phone:315-361-4353
Mailing Address - Fax:315-363-2015
Practice Address - Street 1:227 W SENECA ST
Practice Address - Street 2:
Practice Address - City:SHERRILL
Practice Address - State:NY
Practice Address - Zip Code:13461-1152
Practice Address - Country:US
Practice Address - Phone:315-363-3099
Practice Address - Fax:315-363-2015
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55407BMedicare ID - Type Unspecified