Provider Demographics
NPI:1831470046
Name:KELTER, WALTER (RPH)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:
Last Name:KELTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NORTHROP TER
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904-2307
Mailing Address - Country:US
Mailing Address - Phone:617-240-9595
Mailing Address - Fax:
Practice Address - Street 1:48 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2124
Practice Address - Country:US
Practice Address - Phone:603-772-3551
Practice Address - Fax:603-773-9968
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist