Individual
DOMINIQUE VALANCIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
379 COUNTY ROUTE 40, MASSENA, NY 13662-3427
(315) 322-2512
Mailing address
379 COUNTY ROUTE 40, MASSENA, NY 13662-3427
(315) 322-2512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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