Individual
JEREMY WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
523 S STERLING VISTAS WAY, VAIL, AZ 85641-2286
(520) 401-7745
Mailing address
523 S STERLING VISTAS WAY, VAIL, AZ 85641-2286
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4988
AZ
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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