Individual
DR. WALTER LE RROY ELAM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
761 MIDDLE ST, FAIRHOPE, AL 36532-1715
(251) 928-4750
(251) 990-2560
Mailing address
153 ORANGE AVE, FAIRHOPE, AL 36532-1227
(251) 990-3596
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
15
AL
Other
Enumeration date
05/10/2006
Last updated
02/03/2010
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