Individual
GRACE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1509 ROUTE 38 STE 8, HAINESPORT, NJ 08036-2981
(609) 784-8426
Mailing address
1509 ROUTE 38 STE 8, HAINESPORT, NJ 08036-2981
(609) 784-8426
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA02300800
NJ
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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