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1578189270
ELLIS B WALL
MOORESVILLE, NC
NPI
1578189270
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NC P19348)
Enumeration Date
2020-06-19
Last Update Date
2020-06-19
Business Address
ELLIS B WALL
136 CORPORATE PARK DR
MOORESVILLE, NC 28117-6959
Phone number: 919-449-7954
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Mailing Address
ELLIS B WALL
13545 KINTYRE CT
MATTHEWS, NC 28105-3032
Phone number: 919-449-7954
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