Individual
RANDY WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
271 DODDSON FORK RD, MORRISVALE, WV 25565-9590
(304) 549-0927
Mailing address
271 DODDSON FORK RD, MORRISVALE, WV 25565-9590
(304) 549-0927
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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