| NPI | 1902114382 |
|---|---|
| Former Name | MELANIE ANN WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 28458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 28458) |
| Enumeration Date | 2010-09-19 |
| Last Update Date | 2020-11-18 |