Provider Demographics
NPI:1609025113
Name:VALUSEK, MATTHEW JUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JUSTIN
Last Name:VALUSEK
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 1:1073 ROSS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4371
Mailing Address - Country:US
Mailing Address - Phone:760-352-1452
Mailing Address - Fax:760-352-3966
Practice Address - Street 1:1073 ROSS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4371
Practice Address - Country:US
Practice Address - Phone:760-352-1452
Practice Address - Fax:760-352-3966
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor