Provider Demographics
NPI:1013426402
Name:VALENTINE, JOSHUA PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:PAUL
Last Name:VALENTINE
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 1:554 W RALPH HALL PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6644
Mailing Address - Country:US
Mailing Address - Phone:972-771-3388
Mailing Address - Fax:
Practice Address - Street 1:554 W RALPH HALL PKWY
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6644
Practice Address - Country:US
Practice Address - Phone:972-771-3388
Practice Address - Fax:972-722-3398
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor