Individual
DWAYNE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
631 RB WILSON DR, HUNTINGDON, TN 38344-1727
(731) 986-7096
(731) 986-7088
Mailing address
631 RB WILSON DR, HUNTINGDON, TN 38344-1727
(731) 986-7096
(731) 986-7088
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
0000130594
TN
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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