Individual
MYRA WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 W TABOR RD APT 2, PHILADELPHIA, PA 19120-2723
(267) 357-9405
Mailing address
525 W TABOR RD APT 2, PHILADELPHIA, PA 19120-2723
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
65953601
PA
Other
Enumeration date
05/06/2022
Last updated
05/06/2022
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