Individual
DR. GREGORY L WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5219 PETERS CREEK RD NW, SUITE 5, ROANOKE, VA 24019-3864
(540) 362-0811
(540) 362-5025
Mailing address
8521 BARRENS RD, ROANOKE, VA 24019-6705
(540) 563-0487
(540) 362-5025
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000425
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018116
ANTHEM PROVIDER NUMBER
VA
Enumeration date
06/21/2005
Last updated
06/09/2010
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