Philly Marie Wall, P.A.

NPI #1497894117 in Cedar Rapids, Iowa

Provider Information

NPI Number: 1497894117
Entity Type: Individual
Name: Philly Marie Wall, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Feb 6, 2007
Last Updated: Nov 18, 2021

Practice Location

Address: 830 4TH AVE SE STE 1
City: Cedar Rapids
State: Iowa
ZIP Code: 52403-2445
Phone: (402) 650-6765

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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