Individual
ANTONIO BRIAN WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 239-8514
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 239-8514
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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