Individual
MR. JEREMY LEE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
514 WINNIPEG AVE, DULUTH, MN 55806-1449
(218) 349-4813
Mailing address
514 WINNIPEG AVE, DULUTH, MN 55806-1449
(218) 349-4813
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
104284
MN
225X00000X
Occupational Therapist
OC012508
PA
225X00000X
Occupational Therapist
Primary
U1-001358
DE
Other
Enumeration date
12/26/2012
Last updated
09/04/2013
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