Individual
MR. WALTER C. NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25405 PERDIDO BLVD, ORANGE BEACH, AL 36561
(251) 981-1796
Mailing address
811 E 24TH AVE, GULF SHORES, AL 36542-3113
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7918
AL
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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