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Dr. Walter Cary Letien

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NPI Number Detailed Information

Provider Information:

Name: Dr. Walter Cary Letien
Gender: M
Provider License Number If Given: 123

NPI Information:

NPI: 1023011061
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/9/2007

Provider Business Mailing Address:

Address: 266 CABOT ST P.O. BOX 488
Beverly, MA 01915
Phone Number: 9789221888
Fax Number: 9789274608

Provider Business Practice Location Address:

Address: 266 CABOT ST SUITE 3
Beverly, MA 01915
Phone Number: 9789221888
Fax Number: 9789274608

Provider Taxonomy:

Primary: 231H00000X
Secondary (if any): 237600000X
State: MA

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