Individual
DANIEL RAY WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
310 S DIVISION ST APT 3, DU QUOIN, IL 62832-1881
(618) 318-7193
Mailing address
310 S DIVISION ST APT 3, DU QUOIN, IL 62832-1881
(618) 318-7193
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057005498
IL
Other
Enumeration date
07/10/2021
Last updated
07/10/2021
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