Individual
MR. GEORGE THOMAS WALLS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7600 AUTUMN PARK WAY, MECHANICSVILLE, VA 23116-3868
(804) 730-0009
Mailing address
7600 AUTUMN PARK WAY, MECHANICSVILLE, VA 23116-3868
(804) 730-0009
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000254
VA
225XE0001X
Environmental Modification Occupational Therapist
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Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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