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NPI Code Detail

MEDICARE: JAMES WALL

MEDICARE: JAMES WALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT4537ME

General Provider Information

NPI Number : 1083167456
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES WALL
Provider Business Mailing Address
First Line : 16 OLD PIKE RD
Second Line :
City : CORNISH
State : ME
Zip : 04020-3506
Country : US
Telephone Number : 207-625-4300
Fax Number :
Provider Business Practice Location Address
First Line : 16 OLD PIKE RD
Second Line :
City : CORNISH
State : ME
Zip : 04020-3506
Country : US
Telephone Number : 207-625-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2016
Last Update Date : 09/08/2023

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