Individual
SUSAN A WALTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, ANN ARBOR, MI 48105-9484
(734) 998-7400
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4704119195
MI
363L00000X
Nurse Practitioner
Primary
4704119195
MI
Other
Enumeration date
03/03/2006
Last updated
12/23/2009
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