Individual
DR. MARY A WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1174 WYOMING AVE, FORTY FORT, PA 18704-4016
(570) 288-9444
(570) 331-7543
Mailing address
1174 WYOMING AVE, FORTY FORT, PA 18704-4016
(570) 288-9444
(570) 331-7543
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC003725L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072962
FIRST PRIORITY
PA
01
—
181952
BC BS
PA
Enumeration date
07/31/2006
Last updated
07/08/2007
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