Individual
KRISTOPHER JAY VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
265 CENTER ST, SEVILLE, OH 44273-8864
(330) 769-4677
Mailing address
265 CENTER ST, SEVILLE, OH 44273-8864
(330) 769-4677
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.014382
OH
225100000X
Physical Therapist
PTH5321
AL
Other
Enumeration date
07/10/2008
Last updated
12/17/2013
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