Individual
DAYNA WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 NE STALLINGS DR, NACOGDOCHES, TX 75961-5952
(936) 564-1134
Mailing address
1756 FM 1087, NACOGDOCHES, TX 75965-8660
(936) 596-6180
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2047710
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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