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Individual

DR. BRENT N WALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C

Contact information

Practice address
205 N MAIN ST, SPANISH FORK, UT 84660-1726
(801) 798-2515
(801) 798-2510
Mailing address
205 N MAIN ST, SPANISH FORK, UT 84660-1726
(801) 798-2515
(801) 798-2510

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6089352-1202
UT

Other

Enumeration date
07/25/2006
Last updated
05/23/2016
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