Individual
DR. KEVIN WALP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
(316) 258-0733
Mailing address
710 SASHA LN, TAHLEQUAH, OK 74464-6202
(316) 258-0733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3281
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/28/2024
Last updated
08/14/2024
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