Provider Demographics
NPI:1952448656
Name:JAMES L WALSH DC PA
Entity Type:Organization
Organization Name:JAMES L WALSH DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-671-3100
Mailing Address - Street 1:1701 NE 42ND AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-8022
Mailing Address - Country:US
Mailing Address - Phone:352-671-3100
Mailing Address - Fax:352-236-0815
Practice Address - Street 1:1701 NE 42ND AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-8022
Practice Address - Country:US
Practice Address - Phone:352-671-3100
Practice Address - Fax:352-236-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty