Individual
JOHN P WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSOTR'L
Contact information
Practice address
2 BON AIRE TER, PITTSTON, PA 18640-3202
(570) 983-9173
(570) 655-4706
Mailing address
2 BON AIRE TER, PITTSTON, PA 18640-3202
(570) 983-9173
(570) 655-4706
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC006873L
PA
Other
Enumeration date
03/31/2007
Last updated
07/08/2007
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