Provider Demographics
NPI:1932363223
Name:VALDEZ, RODELMIRO (CMT)
Entity Type:Individual
Prefix:MR
First Name:RODELMIRO
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6921 E GARTH CIR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-5922
Mailing Address - Country:US
Mailing Address - Phone:907-376-1633
Mailing Address - Fax:
Practice Address - Street 1:6921 E GARTH CIR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-5922
Practice Address - Country:US
Practice Address - Phone:907-376-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist