Individual
DR. MARY BARTUCCIO VALENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1225 MADISON AVE, MEMPHIS, TN 38104-2211
(901) 722-3656
Mailing address
1225 MADISON AVE, MEMPHIS, TN 38104-2211
(901) 722-3656
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3081
TN
152WP0200X
Pediatric Optometrist
Primary
3081
TN
152WP0200X
Pediatric Optometrist
OPC3082
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620411200
—
FL
Enumeration date
10/27/2006
Last updated
02/08/2019
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