Individual
LISE S WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5 CALIENTE RD, STE 2A, SANTA FE, NM 87508-9100
(505) 466-1429
(505) 466-1437
Mailing address
5 CALIENTE RD, STE 2A, SANTA FE, NM 87508-9100
(505) 466-1429
(505) 466-1437
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1683
NM
Other
Enumeration date
11/16/2006
Last updated
06/18/2011
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