Individual
CAROLE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
49 ROLLING LN, LEVITTOWN, PA 19055-1112
(215) 946-8111
Mailing address
49 ROLLING LN, LEVITTOWN, PA 19055-1112
(215) 946-8111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA002364-L
PA
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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