Individual
CHANETTA WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 CAMPBELLTON RD SW, ATLANTA, GA 30311-4607
(678) 704-3905
(770) 994-9894
Mailing address
2221 CAMPBELLTON RD SW, ATLANTA, GA 30311-4607
(678) 704-3905
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO039588
GA
Other
Enumeration date
10/29/2013
Last updated
11/10/2013
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