Individual
DR. RAY CHRISTIAN VAN DE WALKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1112 E CENTRE AVE, SUITE C, PORTAGE, MI 49002-5575
(269) 978-3000
(269) 978-3001
Mailing address
1112 E CENTRE AVE, SUITE C, PORTAGE, MI 49002-5575
(269) 978-3000
(269) 978-3001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008479
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950C95062
BLUE CROSS
MI
Enumeration date
04/05/2006
Last updated
07/08/2007
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