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Contact Information

LAURA C WALL, OT
444 PARK WEST DR.
GROVETOWN, GA30809
 Phone: 706-868-6543
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LAURA C WALL · (Female)

NPI # 1033286679
Status Active
Credentials OT (Occupational Therapist)
Entity Individual
Enumeration date 11/29/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # OT003594
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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