Individual
JENNIFER WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAT, ATC
Contact information
Practice address
2362 E STATE ROAD 18, FLORA, IN 46929-8201
(574) 967-5100
Mailing address
5155 SADDLE DR, LAFAYETTE, IN 47905-7698
(765) 585-5977
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
36001786A
IN
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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