Daniel Ray Walton, COTA
Occupational Therapy Assistant in Du Quoin, IL. Individual provider (NPI-1).
NPI number1164094116
StatusActive
Last updated in NPPESJul 10, 2021
Details
- NPI
- 1164094116
- Entity type
- Individual (NPI-1)
- Name
- Daniel Ray Walton
- Credential
- COTA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 10, 2021
- Certification date
- Jul 10, 2021
- Last updated
- Jul 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 057005498 | IL | Yes |
Practice location
310 S Division St Apt 3Du Quoin, IL 62832-1881
Phone 618-318-7193
Mailing address
310 S Division St Apt 3Du Quoin, IL 62832-1881
Phone 618-318-7193
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