Provider Demographics
NPI:1750717096
Name:ALUISY, VALERIE BRANNON (PT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:BRANNON
Last Name:ALUISY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 BLAKEFORD WAY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5392
Mailing Address - Country:US
Mailing Address - Phone:770-843-9788
Mailing Address - Fax:
Practice Address - Street 1:4255 WADE GREEN RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1762
Practice Address - Country:US
Practice Address - Phone:770-843-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT004420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist