Organization
WALL WELLNESS & ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORETTA WALL DNP (OWNER)
(817) 247-0034
Entity
Organization
Contact information
Practice address
6646 GARY RD STE A, BYRAM, MS 39272-9718
(601) 281-5357
Mailing address
PO BOX 1063, MANSFIELD, TX 76063-1063
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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