VAN WALL

FORT BRAGG, NC
NPI1497175384
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: NC  2018-00185)
Enumeration Date2014-04-18
Last Update Date2018-07-18
Business Address
VAN WALL
2817 REILLY ST
FORT BRAGG, NC 28310
Phone number: 910-907-6000
Mailing Address
VAN WALL
9040 FITZSIMMONS DR
JOINT BASE LEWIS MCCHORD, WA 98431-1000
Phone number: 253-968-2997
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