Individual
KRISTINE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1110 LUCERNE ST, NORWOOD, CO 81423
(970) 327-4567
Mailing address
PO BOX 1124, NORWOOD, CO 81423-1124
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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