Individual
PELLE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 N TENAYA WAY, LAS VEGAS, NV 89128-0436
(725) 377-3655
Mailing address
3678 FALLON CIR, SAN DIEGO, CA 92130-1872
(801) 891-0413
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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