Individual
MR. GREGORY A WALTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
OF INTERCOLLEGIATE ATHLETICS, ICA BUILDING, SANTA BARBARA, CA 93106-5200
(805) 893-3424
(805) 893-5420
Mailing address
PO BOX 1231, GOLETA, CA 93116-1231
(541) 285-6766
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/27/2006
Last updated
07/08/2007
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