Individual
BERNADETTE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(800) 804-9961
Mailing address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(800) 804-9961
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA22317
FL
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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