Individual
MICHAEL W WOLTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9213
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
754493600
—
MN
Enumeration date
01/26/2006
Last updated
11/08/2012
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