Individual
KAELEN CHRISTINE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 4TH AVE E, POLSON, MT 59860-2117
(406) 745-3525
Mailing address
1202 2ND ST W, POLSON, MT 59860-5314
(406) 261-7380
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
146223
MT
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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