JOHN M WALTER

ROCKFORD, IL
NPI1598837940
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096-000576)
Enumeration Date2006-11-14
Last Update Date2007-07-08
Business Address
-- JOHN M WALTER ATC
3616 N MAIN ST
ROCKFORD, IL 61103-2159
Phone number: 815-877-5932
Mailing Address
-- JOHN M WALTER ATC
3616 N MAIN ST
ROCKFORD, IL 61103-2159
Phone number: 815-877-5932
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