Individual
LIA MARIE WALTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6845 RANCHO LOS PAVOS LN, GRANITE BAY, CA 95746-7349
(916) 768-7326
Mailing address
6845 RANCHO LOS PAVOS LN, GRANITE BAY, CA 95746-7349
(916) 768-7326
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
6572
CA
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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