NPI 1053359208

Clinton Barrett Wallis, OT

Practitioner Specialist Mobile, AL

Practice location

Address: 709 Downtowner Loop W, Mobile, AL 36609-5503
Phone: (251) 380-1111
Fax: (251) 380-1110

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 2224 (AL)

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Registry record

NPI: 1053359208
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Jun 2006
Record last updated: 24 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.