Organization
WALL MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J WALL MD (OWNER)
(801) 294-6907
Entity
Organization
Contact information
Practice address
8074 S 1300 E, SANDY, UT 84094-0743
(801) 565-6500
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(801) 294-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
180274-1205
UT
Other
Enumeration date
11/03/2006
Last updated
11/09/2010
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