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Individual

MR. STEPHEN VALLETTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.C.P

Contact information

Practice address
8121 N 18TH WAY, PHOENIX, AZ 85020-3965
(602) 513-9568
(480) 777-1345
Mailing address
PO BOX 27588, TEMPE, AZ 85285-7588
(480) 777-0607
(480) 777-1345

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
901224
AZ
Enumeration date
07/17/2006
Last updated
07/08/2007
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