Individual
MR. JOHNNIE HENDERSON WALTON VI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
190 RYLAND ST APT 4101, SAN JOSE, CA 95110-3907
(650) 861-9715
Mailing address
190 RYLAND ST APT 4101, SAN JOSE, CA 95110-3907
(650) 861-9715
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/13/2019
Last updated
05/28/2024
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