Individual
MR. CHANCE WALTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 DUNCAN RD, BUCKEYE, WV 24924-9037
(304) 799-7400
Mailing address
PO BOX 242, GREEN BANK, WV 24944-0242
(304) 456-5481
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
121689
WV
Other
Enumeration date
12/09/2024
Last updated
01/06/2025
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