Provider Demographics
NPI:1831484435
Name:MAUNTON, VAL C (CPED)
Entity Type:Individual
Prefix:MR
First Name:VAL
Middle Name:C
Last Name:MAUNTON
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7485 N ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3204
Mailing Address - Country:US
Mailing Address - Phone:719-278-3668
Mailing Address - Fax:719-278-3433
Practice Address - Street 1:7485 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3204
Practice Address - Country:US
Practice Address - Phone:719-278-3668
Practice Address - Fax:719-278-3433
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0595174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist