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Individual

JOSE ANTONIO VALLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
842 S GRANT ST, SOUTH BEND, IN 46619-3606
(574) 440-9748
Mailing address
842 S GRANT ST, SOUTH BEND, IN 46619-3606
(574) 440-9748

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
12/07/2023
Last updated
12/07/2023
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