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General NPI Number Information
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NPI Number | 1831394964
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Entity Type | Organization
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Legal Business Name | KIM WALTERS OD PA
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 49 N BUNCOMBE SCHOOL RD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9608
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Country | US
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Telephone | 828-645-0061
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Fax | 828-645-0602
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Provider Business Mailing Address
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Address Line | PO BOX 564
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City | WEAVERVILLE
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State | NC
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Zip | 28787-0564
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Country | US
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Telephone | 828-645-0061
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Fax | 828-645-0602
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Authorized Official
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Title or Position | DOCTOR
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Name | MRS. KIMBERLEY DAWN WALTERS
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Credential | O.D., P.A.
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Telephone | 828-645-0061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1726
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License Number State | NC
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