Individual
KATHERINE WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RDMS, RVT
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-8000
(614) 293-3124
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005048RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0209620
—
OH
Enumeration date
01/18/2017
Last updated
11/19/2020
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