Individual
MR. MATTHEW VALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1605 E RIVERSIDE DR, EAGLE, ID 83616-6237
(208) 939-6227
(208) 939-6442
Mailing address
1605 E RIVERSIDE DR, EAGLE, ID 83616-6237
(208) 939-6227
(208) 939-6442
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-809
ID
363AS0400X
Surgical Physician Assistant
PA-809
ID
Other
Enumeration date
08/31/2009
Last updated
11/03/2022
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