Individual
JILL SHANNON WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CA
Contact information
Practice address
432 WATER ST, PRAIRIE DU SAC, WI 53578-1127
(608) 441-9355
Mailing address
21 S JOHN ST, MAZOMANIE, WI 53560-9320
(512) 769-7694
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
2008-55
WI
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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