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Individual

JIM WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6706 SEA ROBIN PL, TAMPA, FL 33615-2548
(813) 758-0319
(866) 463-4875
Mailing address
6706 SEA ROBIN PL, TAMPA, FL 33615-2548
(813) 758-0319
(866) 463-4875

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
03/09/2009
Last updated
03/09/2009
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