Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | OT-520 | ID |
N | 225XE1200X | Ergonomics | OT-520 | ID |
N | 225XH1200X | Occupational Therapist - Hand | OT-520 | ID |
N | 225XM0800X | Mental Health | OT-520 | ID |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT-520 | ID |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT-520 | ID |
NPI | 1033364021 |
---|---|
Provider Name | Dr. Charles K. Walters |
First Address | Colorado Springs, CO 80920-5321 |
Second Address | Fort Carson, CO 80913-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 18/11/2008 |