Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1093059560 |
---|---|
Provider Name | Donna Weidmann Walter |
First Address | Fort Collins, CO 80524-4427 |
Second Address | Fort Collins, CO 80524-4427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2012 |
Last Update Date | 21/11/2012 |