Individual
JASON WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 BULLDOG LN, HAZARD, KY 41701-6081
(859) 254-1035
(859) 254-2075
Mailing address
2250 THUNDERSTICK DR, 1104, LEXINGTON, KY 40505-9415
(859) 254-1035
(859) 254-2075
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
09/16/2010
Last updated
10/10/2024
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