NPI | 1104967074 |
---|---|
Doing Business As | WALWORTH MEDICAL ASSOCIATES |
Entity Type | Organization |
Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD055890L) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2012-10-16 |