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1265002836
MIKAYLA WALL
SALEM, VA
NPI
1265002836
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110008117)
Enumeration Date
2021-06-28
Last Update Date
2021-10-08
Business Address
MIKAYLA WALL
1802 BRAEBURN DR
SALEM, VA 24153-7357
Phone number: 540-772-3702
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Mailing Address
MIKAYLA WALL
434 SUNBURST RD
LYNCHBURG, VA 24501-7249
Phone number: 434-944-2860
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