Individual
MR. MICHAEL EDWARD WHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6116
Mailing address
5601 CHALLISFORD LN, CHARLOTTE, NC 28226-2627
(706) 614-8689
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/11/2017
Last updated
03/11/2017
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