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Individual

MR. CHRISTOPHER BRIAN WALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
980 HIGHWAY 28, SUITE 100, JASPER, TN 37347-3695
(423) 942-1602
(423) 942-1265
Mailing address
980 HIGHWAY 28, SUITE 100, JASPER, TN 37347-3695
(423) 942-1602
(423) 942-1265

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15977
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003118413B
GA
05
1525594
TN
Enumeration date
08/08/2011
Last updated
07/03/2015
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