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1104234145
JOSHUA WALL
GAINESVILLE, FL
NPI
1104234145
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL AL 3641)
Enumeration Date
2014-07-22
Last Update Date
2014-07-22
Business Address
-- JOSHUA WALL ATC, LAT
1900 NW 13TH ST
GAINESVILLE, FL 32609-3411
Phone number: 336-908-2598
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Mailing Address
-- JOSHUA WALL ATC, LAT
1015 NW 21ST AVE APT 127
GAINESVILLE, FL 32609-3448
Phone number: 336-908-2598
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