Individual
DR. MARY JANE WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
11 FLORIDA PARK DR, PALM COAST, FL 32137
(386) 445-4734
(386) 445-8411
Mailing address
11 FLORIDA PARK DR, PALM COAST, FL 32137
(386) 445-4734
(386) 445-8411
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO-1735
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO-1735
FL
213ER0200X
Radiology Podiatrist
PO1735
FL
213ES0000X
Sports Medicine Podiatrist
PO1735
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO1735
FL
213ES0131X
Foot Surgery Podiatrist
PO-1735
FL
Other
Enumeration date
08/24/2006
Last updated
03/29/2012
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