Provider Demographics
NPI:1548238041
Name:VALENTINE, KIMBERLY A (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:A
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ALLENS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3228
Mailing Address - Country:US
Mailing Address - Phone:585-381-2880
Mailing Address - Fax:585-442-1017
Practice Address - Street 1:45 GOODWAY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-3029
Practice Address - Country:US
Practice Address - Phone:585-381-2880
Practice Address - Fax:585-442-1017
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-006251-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10186BMedicare ID - Type Unspecified