NPI 1386794717

Michael Dwayne Wall, PAATCPTACEAS

Practitioner Physician Assistant Powell, TN

Practice location

Address: 7557 Dannaher Way Suite 230, Powell, TN 37849-3558
Phone: (865) 938-5222
Fax: (865) 938-5264
Mailing address: 217 John Bouldin Dr, Maryville, TN 37801-1902

Registered specialties (3)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PENDING (TN)

Other Physician Assistant providers in Tennessee →

Physical Therapy Assistant

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 3396 (TN)

Other Physical Therapy Assistant providers in Tennessee →

Athletic Trainer

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 110102223 (TN)

Other Specialist/Technologist providers in Tennessee →

Registry record

NPI: 1386794717
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jan 2007
Record last updated: 14 Jun 2010

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.