Individual
JARED B WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CST/CSFA
Contact information
Practice address
4205 WILSHIRE DR, VALDOSTA, GA 31605-7023
(229) 630-6027
Mailing address
4205 WILSHIRE DR, VALDOSTA, GA 31605-7023
(229) 630-6027
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
121136
GA
Other
Enumeration date
07/19/2010
Last updated
11/19/2011
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