Individual
DR. GARY BRYAN WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
W62N221 WASHINGTON AVE, CEDARBURG, WI 53012-2726
(262) 377-9686
(262) 377-8462
Mailing address
W62N221 WASHINGTON AVE, CEDARBURG, WI 53012-2726
(262) 377-9686
(262) 377-8462
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1704
WI
152WL0500X
Low Vision Rehabilitation Optometrist
1704
WI
Other
Enumeration date
03/05/2007
Last updated
04/02/2008
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