Provider Demographics
NPI:1487376422
Name:VALLEY MEDICAL HOLDINGS, INC
Entity type:Organization
Organization Name:VALLEY MEDICAL HOLDINGS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-899-1680
Mailing Address - Street 1:6291 PINE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-9728
Mailing Address - Country:US
Mailing Address - Phone:517-899-1680
Mailing Address - Fax:
Practice Address - Street 1:5142 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1038
Practice Address - Country:US
Practice Address - Phone:810-733-3660
Practice Address - Fax:810-733-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty