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Individual

JOHN C WALTHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
1735 TAYLOR ST, COLUMBIA, SC 29201-3452
(803) 254-8449
Mailing address
148 WELCHMAN AVE, GOOSE CREEK, SC 29445-7152
(843) 327-6616

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
67298
SC

Other

Enumeration date
07/26/2005
Last updated
10/14/2010
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