Tracey Wall, PA-C

NPI #1306038492 in Craig, Colorado

Provider Information

NPI Number: 1306038492
Entity Type: Individual
Name: Tracey Wall, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Aug 14, 2007
Last Updated: Apr 12, 2017

Practice Location

Address: 785 RUSSELL ST
City: Craig
State: Colorado
ZIP Code: 81625-2019
Phone: (970) 826-2300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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