Individual
MARK WAYNE WALTERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
306 CHESTNUT ST, VIRGINIA, MN 55792-2524
(218) 749-6333
(218) 749-2731
Mailing address
11405 TOWN LINE RD, HIBBING, MN 55746-8149
(218) 263-3553
(218) 263-3553
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113186-8
MN
Other
Enumeration date
08/01/2005
Last updated
07/08/2007
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