Individual
DR. ANGELA RENEE VANDER WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2580 LAKE AVE, NORTH MUSKEGON, MI 49445-3323
(231) 744-2401
Mailing address
1701 PRINCESS LN, MUSKEGON, MI 49445-1739
(231) 329-4941
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302037940
MI
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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