Individual
AUSTIN WALTON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
581 MAIN ST STE 640, WOODBRIDGE, NJ 07095-1196
(732) 204-1636
Mailing address
581 MAIN ST STE 640, WOODBRIDGE, NJ 07095-1196
(732) 204-1636
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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