Individual
DR. JASON W WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
115 1ST AVE W, DYERSVILLE, IA 52040-1104
(563) 875-9255
Mailing address
115 1ST AVE W, DYERSVILLE, IA 52040-1104
(563) 875-9255
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A06211
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48459
INDVIDUAL PROVIDER #
IA
Enumeration date
01/15/2007
Last updated
02/26/2021
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