Individual
WALTER NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
472 KENSINGTON DR APT 213, ROCHESTER HILLS, MI 48307-4064
(630) 363-6324
Mailing address
472 KENSINGTON DR APT 213, ROCHESTER HILLS, MI 48307-4064
(630) 363-6324
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1701046556
MI
Other
Enumeration date
03/25/2018
Last updated
03/25/2018
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