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1164981452
JOEL WALLIS
PROVO, UT
NPI
1164981452
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2019-03-15
Last Update Date
2021-03-29
Business Address
JOEL WALLIS
1933 N 1120 W
PROVO, UT 84604-1044
Phone number: 801-683-6830
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Mailing Address
JOEL WALLIS
177 S 1050 W APT 20
PROVO, UT 84601-7067
Phone number: 385-208-7054
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