Individual
THEODORE LAURENCE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
223 W MAIN ST, RAVENNA, OH 44266-2741
(330) 577-4099
(844) 274-3002
Mailing address
223 W MAIN ST, RAVENNA, OH 44266-2741
(330) 577-4099
(844) 274-3002
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005855
OH
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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