Individual
KYLE MARK WALKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 947-0673
(801) 740-2847
Mailing address
4624 N SPIDER LAKE RD, TRAVERSE CITY, MI 49696-8440
(231) 947-0673
(801) 740-2847
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006155
MI
Other
Enumeration date
09/13/2011
Last updated
07/27/2023
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