Individual
BRYCE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, AT-C
Contact information
Practice address
12112 W KELLOGG ST, WICHITA, KS 67235-1100
(316) 440-1100
(316) 440-1089
Mailing address
12112 W KELLOGG ST, WICHITA, KS 67235-1100
(316) 440-1100
(316) 440-1089
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00695
KS
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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