Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 98-528 | AZ |
NPI | 1083735658 |
---|---|
Provider Name | Dr. Sam J Walters |
First Address | Scottsdale, AZ 85255-1818 |
Second Address | Scottsdale, AZ 85258-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |