Individual
PERCIVAL VALENZUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1865 COVE RD, BLDG 3806, NORFOLK, VA 23521-2911
(757) 462-3780
(757) 462-4825
Mailing address
1865 COVE RD, BLDG 3806, NORFOLK, VA 23521-2911
(757) 462-3780
(757) 462-4825
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
B1505257
ZZ
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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