Individual
JAMES WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 OLD PIKE RD, CORNISH, ME 04020-3506
(207) 625-4300
Mailing address
16 OLD PIKE RD, CORNISH, ME 04020-3506
(207) 625-4300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4537
ME
Other
Enumeration date
08/02/2016
Last updated
09/08/2023
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