Individual
LARRY WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7523 BUCHANAN STREET, APT 242, LANDOVER HILLS, MD 20784
(240) 901-0484
Mailing address
7523 BUCHANAN ST APT 242, LANDOVER HILLS, MD 20784-2389
(240) 901-0484
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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