Individual
HEATHER LEE WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
7482 TOWNSHIP ROAD 32, JENERA, OH 45841-8915
(419) 420-5417
Mailing address
7482 TOWNSHIP ROAD 32, JENERA, OH 45841-8915
(419) 420-5417
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
07364
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RT326022
DRIVER'S LICENSE
OH
Enumeration date
11/10/2022
Last updated
11/10/2022
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