Provider Demographics
NPI:1982614327
Name:VALUSEK, WILLIAM P (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:VALUSEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1030 BROADWAY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2337
Mailing Address - Country:US
Mailing Address - Phone:760-352-1452
Mailing Address - Fax:760-352-3966
Practice Address - Street 1:1030 BROADWAY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2337
Practice Address - Country:US
Practice Address - Phone:760-352-1452
Practice Address - Fax:760-352-3966
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC10435111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
T03933Medicare UPIN