Organization
MICHAEL WALL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WALL PA (OWNER)
(865) 995-4643
Entity
Organization
Contact information
Practice address
362 HIGH ST, MARYVILLE, TN 37804-5835
(865) 413-1589
(865) 205-9475
Mailing address
PO BOX 5777, MARYVILLE, TN 37802-5777
(865) 246-2104
(865) 246-2106
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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