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Individual

MR. ROBERT WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2910 BRIARCLIFFE RD, WINSTON SALEM, NC 27106-3176
(336) 399-0178
Mailing address
433 STICKNEY RD, WINSTON SALEM, NC 27107-5518
(336) 399-0178

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4991
NC

Other

Enumeration date
12/27/2016
Last updated
12/27/2016
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