Individual
JESSICA WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1808 KING ST, VESTAL, NY 13850-1912
(607) 643-2656
Mailing address
220 TERRACE ST, DUNMORE, PA 18512-3046
(607) 643-2656
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/06/2016
Last updated
05/09/2025
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