Individual
WALT LANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 GRATIOT BLVD, MARYSVILLE, MI 48040-1145
(810) 388-1200
Mailing address
4541 24TH AVE, APT # 3, FORT GRATIOT, MI 48059-3472
(810) 388-1200
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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