Most Relevant Information
Provider Data
| NPI Number: | 1003449695 |
| Provider Name: | LIAM C WALL CNA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | CP60700453 |
Most Important Dates
| Enumeration Date: | 02/21/2020 |
| Last Updated: | 02/21/2020 |
Provider Practice Location
1313 N 13TH AVE
WALLA WALLA
WA
993628817
Practice Location Phone/Fax
| Phone: | 5095253610 |
| Fax: |
Provider Mailing Location
1313 N 13TH AVE
WALLA WALLA
WA
993628817
Provider Mailing Phone/Fax
| Phone: | 5095253610 |
| Fax: |