Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 5 | MT |
NPI | 1033391479 |
---|---|
Provider Name | Dr. Ann A. Waltz |
First Address | Kalispell, MT 59901-5005 |
Second Address | Kalispell, MT 59901-5005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2007 |
Last Update Date | 27/11/2007 |