Individual
MATTHEW A WALCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
150 COBBLESTONE LN, BURNSVILLE, MN 55337-4578
(952) 892-2717
Mailing address
2024 GRAND AVE S APT 1, MINNEAPOLIS, MN 55405-3490
(608) 658-5833
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106212
MN
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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