Organization
MICHELLE WALSH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BOLICK WALSH (OWNER)
(828) 381-1221
Entity
Organization
Contact information
Practice address
1415 29TH AVENUE DR NE, HICKORY, NC 28601-7323
(828) 855-3445
(828) 855-2840
Mailing address
1415 29TH AVENUE DR NE, HICKORY, NC 28601-7323
(828) 855-3445
(828) 855-2840
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
600604865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704649
—
NC
Enumeration date
12/04/2006
Last updated
04/08/2014
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