Individual
MRS. CHERYL K WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
414 W MAIN ST, LAKE CITY, SC 29560-2318
(843) 374-7378
(843) 374-7379
Mailing address
414 W MAIN ST, LAKE CITY, SC 29560-2318
(843) 374-7378
(843) 374-7379
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1089
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1089
LICENSE NUMBER
SC
05
—
TH0066
—
SC
Enumeration date
11/21/2006
Last updated
07/09/2007
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