Individual
CARLY M WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., RPA-C
Contact information
Practice address
817 FOREST AVE, ZANESVILLE, OH 43701-2820
(740) 454-7546
Mailing address
817 FOREST AVE, ZANESVILLE, OH 43701-2820
(740) 454-7546
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50005259RX
OH
Other
Enumeration date
10/04/2009
Last updated
01/26/2021
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