Individual
JASON T WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46895
MN
Other
Enumeration date
07/17/2006
Last updated
04/05/2012
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