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1740480003
LARRY WAYNE WALLS
ABILENE, TX
NPI
1740480003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT0152)
Enumeration Date
2007-07-24
Last Update Date
2007-07-24
Business Address
Mr. LARRY WAYNE WALLS LAT
2432 CRESTLINE DR
ABILENE, TX 79602-6218
Phone number: 325-677-0746
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Mailing Address
Mr. LARRY WAYNE WALLS LAT
2432 CRESTLINE DR
ABILENE, TX 79602-6218
Phone number: 325-677-0746
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