Walton, Samuel Richard

Walton, Samuel Richard is an individual health care provider with primary practice located at 1214 Swan Lake Dr Apt 302 , Charlottesville VA 22902-7266. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Walton, Samuel Richard can be contacted via phone (201) 991-0659.

Contact Information

Primary practice address
1214 Swan Lake Dr Apt 302 Charlottesville VA 22902-7266
Phone: (201) 991-0659
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 0126001872 Virginia

Profile Details

NPI number 1881132942
LBN Legal business name Walton, Samuel Richard
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2017
Last updated Feb 8th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881132942 NPPES
Virginia Other 70802201 ATHLETIC TRAINING BOARD OF CERTIFICATION
Virginia Other 0126001872 ATHLETIC TRAINING BOARD OF CERTIFICATION

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