Individual
ALEXIS WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
704 W BROAD ST, ELIZABETHTOWN, NC 28337-9469
(910) 991-9053
(910) 991-3054
Mailing address
PO BOX 1288, LUMBERTON, NC 28359-1288
(910) 671-9629
(910) 671-9630
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211405
—
NC
Enumeration date
01/26/2022
Last updated
01/26/2022
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