Individual
MR. KEITH P WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
370 COUNTRY CLUB RD STE A, HOLLAND, MI 49423-8303
(616) 836-2896
Mailing address
370 COUNTRY CLUB RD STE A, HOLLAND, MI 49423-8303
(616) 836-2896
(616) 393-2182
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
N438257
MI
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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