Individual
BRIANNA KATHERINE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
16 VINEYARD LN, HARWICH, MA 02645-2455
(774) 209-0612
Mailing address
16 VINEYARD LN, HARWICH, MA 02645-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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