Individual
BOSTON WALTENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1500 N HARRISON AVE, CARY, NC 27513-5549
(919) 228-4682
(919) 677-8761
Mailing address
1500 N HARRISON AVE, CARY, NC 27513-5549
(919) 228-4682
(919) 677-8761
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-2512
NC
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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