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Individual
ROBERT WALLS
Active
Individual
ROBERT WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, ATC,CES,PES,FRC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95414155
CA
2255A2300X
Athletic Trainer
090202007
—
Other
Enumeration date
07/23/2021
Last updated
03/31/2025
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