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Individual

MANUEL ENRIQUE VALENZUELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
8016 PETROGLYPH AVE NW, ALBUQUERQUE, NM 87120-6558
(505) 228-5050
Mailing address
1333 BONITO RD SW, ALBUQUERQUE, NM 87105-4606
(505) 515-9333

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3814
NM

Other

Enumeration date
10/09/2017
Last updated
10/09/2017
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