| Doctor Name: | DR. GARY BRYAN WALTERS |
| NPI Number: | 1285763060 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | O.D. |
| License Number: | 1704 |
| Business Practice Address: | W62n221 Washington Ave Cedarburg, WI - 530122726 |
| Business Phone Number: | 2623779686 |
| Business Fax Number: | 2623778462 |
| Mailing Address: | W62n221 Washington Ave, CEDARBURG |
| State: | WI |
| Postal Code: | 530122726 |
| Phone Number: | 2623779686 |
| Fax Number: | 2623778462 |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 04/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WL0500X |
| License Number: | 1704 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Low Vision Rehabilitation |
| Taxonomy Definition: | Optometrists who specialize in low-vision care having training to assess visual function, prescribe low-vision devices, develop treatment plans, and recommend other vision rehabilitation services. |