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Individual

ANTHONY LEODIS WALLS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8732 N MEYER RD, POST FALLS, ID 83854
(208) 819-4250
Mailing address
8732 N MEYER RD, POST FALLS, ID 83854-4684

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/08/2017
Last updated
06/08/2017
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