Individual
VANCE A. WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
259 E OAKDALE AVE, CRESTVIEW, FL 32539-3547
(850) 689-1234
Mailing address
259 E OAKDALE AVE, CRESTVIEW, FL 32539-3547
(850) 689-1234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH13742
FL
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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