Individual
JENNIFER B WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004538
VA
363A00000X
Physician Assistant
2917
AZ
Other
Enumeration date
07/13/2006
Last updated
07/22/2021
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