Individual
DR. NATHAN RANDALL WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12197 S DRAPER GATE DR, DRAPER, UT 84020-8078
(801) 590-0600
(801) 590-0643
Mailing address
12197 S. DRAPER GATE DR., STE. 108, SILVERDALE, UT 98383-8301
(801) 590-0600
(801) 590-0643
Taxonomy
Speciality
Code
Description
License number
State
111NP0017X
Pediatric Chiropractor
Primary
6145802-1202
UT
Other
Enumeration date
08/13/2012
Last updated
04/04/2018
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