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1225233091
MICHAEL C WALTER
WILLOWBROOK, IL
NPI
1225233091
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2007-06-20
Last Update Date
2007-07-08
Business Address
MICHAEL C WALTER LAT
635 EXECUTIVE DR
WILLOWBROOK, IL 60527-5603
Phone number: 630-455-6630
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Mailing Address
MICHAEL C WALTER LAT
104 EISENHOWER DR CR2
BLOOMINGTON, IL 61701-2060
Phone number:
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