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1770701872
NICHOLAS WALLE
PROVIDENCE, RI
NPI
1770701872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2085R0202X Radiology Diagnostic Radiology
(Licence: RI LP00865)
Enumeration Date
2007-04-23
Last Update Date
2007-07-08
Business Address
NICHOLAS WALLE
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-8450
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Mailing Address
NICHOLAS WALLE
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-8450
Copy
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