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Contact Information

EVAN A WALTERS
104 MAGARET LANE
GRASS VALLEY, CA95945
 Phone: 530-263-8006
 Fax: 530-273-7551
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for EVAN A WALTERS · (Male)

NPI # 1184114779
Status Active
Credentials
Entity Individual
Enumeration date 05/18/2018
Last updated 05/18/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 294652
  • CA Medicaid 294652
  • CA Other 294652 PHYSICAL THERAPIST
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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