Individual
JAN WALDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
727 SE MAIN ST STE 200, SIMPSONVILLE, SC 29681-3262
(864) 454-6670
(864) 454-6675
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/15/2012
Last updated
11/22/2023
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