Individual
CRYSTAL WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4090 HOMESTEAD DR APT 14, BURTON, MI 48529-1657
(810) 282-6874
Mailing address
4090 HOMESTEAD DR APT 18, BURTON, MI 48529-1657
(818) 282-6874
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
383145143
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00027285677001
—
MI
Enumeration date
07/31/2015
Last updated
07/31/2015
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