Individual
SANDRA WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 STOLLINGS CT, GLEN DANIEL, WV 25844-9463
(304) 923-8432
Mailing address
122 STOLLINGS CT, GLEN DANIEL, WV 25844-9463
(304) 923-8432
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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