Mica Walthall, LPN

NPI #1417220625 in Patchogue, New York

Provider Information

NPI Number
1417220625
Entity Type
Individual
Name
Mica Walthall, LPN
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Licensed Practical Nurse
Credential
LPN
Enumeration Date
Feb 17, 2012
Last Updated
Feb 17, 2012

Practice Location

Address
2 MALER LN
ZIP Code
11772-3558
Phone
(631) 639-6682

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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