Individual
CONNIE WALTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
646 HEPBURN ST, REAR APT. 1, MILTON, PA 17847-2466
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN250180L
PA
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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