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Individual

STEPHANIE EILEEN WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH, MSDH, MED, OM

Contact information

Practice address
1800 HOPEMAN LN, MT PLEASANT, SC 29466-9278
(952) 818-5057
Mailing address
1800 HOPEMAN LN, MT PLEASANT, SC 29466-9278
(952) 818-5057

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
04/26/2010
Last updated
04/26/2010
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