Individual
TANJA WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 S LIMIT AVE STE 9, SEDALIA, MO 65301-5116
(660) 826-5885
(660) 826-5174
Mailing address
1400 S LIMIT AVE STE 9, SEDALIA, MO 65301-5116
(660) 287-2454
(660) 826-5174
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
037428
MO
Other
Enumeration date
09/11/2014
Last updated
09/16/2014
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