Mark Wallman's National Provider Identifier (NPI) Details
Mark Wallman, L.P.C., L.C.A.D.C.
NPI: 1164676029
Enumeration Date: 2008-11-05
Last updated: 2009-05-06
Sole Proprietor: YES
Status: active
Postal Address: 314 KELLY LN, BOONTON, NJ
Phone: 973-334-6006
Primary Practice Address: 314 KELLY LN, BOONTON, NJ
Practice's phone: 973-334-6006