JACOB B WALL

BLOOMINGTON, IN
NPI1932770005
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IN  10003433A)
Enumeration Date2021-07-08
Last Update Date2024-01-30
Business Address
JACOB B WALL PA-C
415 S LANDMARK AVE
BLOOMINGTON, IN 47403-5003
Phone number: 812-333-7433
Mailing Address
JACOB B WALL PA-C
801 YORK ST
MANITOWOC, WI 54220-4630
Phone number: 920-663-9008
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