Individual
BERNARD WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 OCHRE POINT AVE, NEWPORT, RI 02840-4149
(401) 341-2391
Mailing address
10 GARFIELD DR, COVENTRY, RI 02816-6209
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT00195
RI
Other
Enumeration date
06/19/2006
Last updated
07/08/2007
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