Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 3653 | FL |
NPI | 1083901995 |
---|---|
Provider Name | Dr. Laura Michelle Walton |
First Address | Daytona Beach Shores, FL 32218 |
Second Address | Daytona Beach, FL 32117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 03/07/2014 |