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Individual
LIA WALL
Active
Individual
LIA WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10562
AZ
225100000X
Physical Therapist
4370
NM
225100000X
Physical Therapist
Primary
5501016229
MI
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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