Individual
HARVEY W WALLMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DSC
Contact information
Practice address
1941 W GUADALUPE RD STE 108, MESA, AZ 85202-7483
(480) 491-3563
Mailing address
17233 N HOLMES BLVD STE 1650, PHOENIX, AZ 85053-2030
(602) 547-1836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-002045
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPT-002045
ARIZONA BOARD OF PHYSICAL THERAPY
AZ
Enumeration date
06/22/2021
Last updated
06/22/2021
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