Individual
EMILY J WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
321 BUTTS AVE, TOMAH, WI 54660-1412
(608) 372-2181
(608) 374-0334
Mailing address
321 BUTTS AVE, TOMAH, WI 54660-1412
(608) 372-2181
(608) 374-0334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6414-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6414-024
WISCONSIN STATE LICENSE
WI
Enumeration date
10/15/2008
Last updated
10/15/2008
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