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NPI Code Detail

MEDICARE: MR. VANCE R WALTON CFO

MEDICARE: MR. VANCE R WALTON CFO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225000000XOrthotic Fitter04891NC

General Provider Information

NPI Number : 1891425930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VANCE R WALTON CFO
Provider Business Mailing Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 336-333-9081
Fax Number : 336-333-9083
Provider Business Practice Location Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 336-333-9081
Fax Number : 336-333-9083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2022
Last Update Date : 07/18/2022

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