James Grant Walther

Individual provider Active NPI Home Modifications Contractor · Aurora, IN

NPI 1831695642 · NPPES record last updated Apr 2, 2018

Key facts

NPI
1831695642
Entity type
Individual (NPI type 1)
Primary specialty
Home Modifications Contractor 171WH0202X
Practice address
16408 Jeanie Drive
Aurora, IN 45014
Phone
(513) 702-0261
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X IN Yes

Addresses

Primary practice location

16408 Jeanie Drive
Aurora, IN 45014

Mailing address

16408 Jeanie Drive
Aurora, IN 45014
Phone (513) 702-0261

Other identifiers

IdentifierTypeStateIssuer
824454651OtherFEDERAL TAX IDENTIFICATION NUMBER

Other providers in Aurora, IN

All providers in Aurora, IN · Home Modifications Contractor in Indiana

Sources for this page

Verify at the official NPI Registry.