Individual
JOSHUA WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2302 S CEDAR AVE, INDEPENDENCE, MO 64052-1653
(816) 719-0104
Mailing address
2302 S CEDAR AVE, INDEPENDENCE, MO 64052-1653
(816) 719-0104
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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