Provider Demographics
NPI:1629137237
Name:WALDER, MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:WALDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 TRIANGLE STREET
Mailing Address - Street 2:STE 4
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002
Mailing Address - Country:US
Mailing Address - Phone:413-549-1500
Mailing Address - Fax:
Practice Address - Street 1:228 TRIANGLE ST STE 4
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2169
Practice Address - Country:US
Practice Address - Phone:413-549-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor