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General NPI Number Information
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NPI Number | 1437372729
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Entity Type | Individual
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Provider Name | WALTER JOSEPH CROOK MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1701 TECHNOLOGY DR NE
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City | WILLMAR
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State | MN
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Zip | 56201-2275
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Country | US
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Telephone | 320-231-5906
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 NE TECHNOLOGY DRIVE
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City | WILLMAR
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State | MN
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Zip | 56201
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Country | US
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Telephone | 320-231-5906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 12201
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License Number State | AL
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