Individual
JESSICA L WALZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9235 GROSSMAN RD, MANCHESTER, MI 48158
(313) 350-0812
Mailing address
9235 GROSSMAN RD, MANCHESTER, MI 48158-8613
(313) 350-0812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/16/2017
Last updated
07/21/2022
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