Walz, Jacqueline

Walz, Jacqueline is an sole proprietor health care provider with primary practice located at 15544 Finch Ave , Apple Valley MN 55124-5823. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Walz, Jacqueline can be contacted via phone (701) 799-8416.

Contact Information

Primary practice address
15544 Finch Ave Apple Valley MN 55124-5823
Phone: (701) 799-8416
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 20075 Minnesota

Profile Details

NPI number 1942974514
LBN Legal business name Walz, Jacqueline
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2021
Last updated Aug 5th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942974514 NPPES
Minnesota MEDICAID M714132000

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