Provider Demographics
NPI:1659811628
Name:VALDEZ, ADDISON KAY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ADDISON
Middle Name:KAY
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-4602
Mailing Address - Country:US
Mailing Address - Phone:515-520-9813
Mailing Address - Fax:
Practice Address - Street 1:80 AMHERST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:IA
Practice Address - Zip Code:50658-9712
Practice Address - Country:US
Practice Address - Phone:641-435-4476
Practice Address - Fax:641-435-4491
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist