Provider Demographics
NPI:1609953520
Name:VAN DEN VALENTYN, WALTER PAUL (DC)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:PAUL
Last Name:VAN DEN VALENTYN
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 1:19922 STONEY POINT WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-5572
Mailing Address - Country:US
Mailing Address - Phone:301-602-8419
Mailing Address - Fax:
Practice Address - Street 1:14800 PHYSICIANS LN
Practice Address - Street 2:SUITE 231
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3940
Practice Address - Country:US
Practice Address - Phone:301-762-6686
Practice Address - Fax:301-762-6646
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor