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1710135199
KEVIN WALL
MARYVILLE, TN
NPI
1710135199
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 2300)
Enumeration Date
2008-08-28
Last Update Date
2008-08-28
Business Address
MR. KEVIN WALL LPTA
307 N 5TH ST
MARYVILLE, TN 37804-2921
Phone number: 865-983-0261
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Mailing Address
MR. KEVIN WALL LPTA
307 N 5TH ST
MARYVILLE, TN 37804-2921
Phone number: 865-983-0261
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