Provider Demographics
NPI:1316073166
Name:VALLIERES, DEBORAH (OD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:VALLIERES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 LOUDON RD
Mailing Address - Street 2:SUITE #1170
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-8005
Mailing Address - Country:US
Mailing Address - Phone:603-223-9606
Mailing Address - Fax:603-717-7106
Practice Address - Street 1:270 LOUDON RD
Practice Address - Street 2:SUITE #1170
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-8005
Practice Address - Country:US
Practice Address - Phone:603-223-9606
Practice Address - Fax:603-717-7106
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist