Jack Walsh

NPI #1932755972 in Fairplay, Colorado

Provider Information

NPI Number: 1932755972
Entity Type: Individual
Name: Jack Walsh
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Enumeration Date: Aug 15, 2019
Last Updated: Aug 15, 2019

Practice Location

Address: 825 CLARK STREET
Address 2: UNIT A
City: Fairplay
State: Colorado
ZIP Code: 80440
Phone: (719) 836-4154

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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