Provider Demographics
NPI:1861443095
Name:VALDEZ, ANDRES B (PT)
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:B
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 LIBERTY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2519
Mailing Address - Country:US
Mailing Address - Phone:513-246-2270
Mailing Address - Fax:
Practice Address - Street 1:8020 LIBERTY WAY
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2519
Practice Address - Country:US
Practice Address - Phone:513-246-2270
Practice Address - Fax:513-860-0713
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT005501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT005501OtherLICENSE