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Individual
MARY WALLMAN
Active
Individual
MARY WALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305003165
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010052319
—
VA
Enumeration date
08/05/2006
Last updated
11/15/2016
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