Individual
EVIN RIDDLE WALLUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1299 103RD AVENUE, PLAINWELL, MI 49080
(269) 598-7370
Mailing address
1299 103RD AVENUE, PLAINWELL, MI 49080
(269) 598-7370
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15227
CA
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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