Provider Demographics
NPI:1831477355
Name:QUETGLAS, VALENTINA
Entity Type:Individual
Prefix:MRS
First Name:VALENTINA
Middle Name:
Last Name:QUETGLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COCHIN TRCE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8244
Mailing Address - Country:US
Mailing Address - Phone:734-693-2111
Mailing Address - Fax:
Practice Address - Street 1:208 COCHIN TRCE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8244
Practice Address - Country:US
Practice Address - Phone:734-693-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program