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Individual
HARRY WALTON
Active
Individual
HARRY WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
12302
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ56437Z
BLUE SHIELD PROVIDER
CA
Enumeration date
12/28/2006
Last updated
02/04/2008
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