Individual
JOANN WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Mailing address
2611 W DEER RUN TRL, DECATUR, IN 46733-7587
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13007002A
IN
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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