Individual
MR. ANTHONY LEE WALTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5000 DEER PARK DR SE, SALEM, OR 97301-9330
(503) 589-8108
(503) 315-2947
Mailing address
5000 DEER PARK DR SE, SALEM, OR 97301-9330
(503) 589-8108
(503) 315-2947
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1008312
OR
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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