Individual
MR. JOSEPH WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4259 ANCHOR DR, MISHAWAKA, IN 46544-9143
(574) 276-1303
Mailing address
4259 ANCHOR DR, MISHAWAKA, IN 46544-9143
(574) 276-1303
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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