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Mr. Clinton Barrett Wallis, OT
Specialist in Mobile, Alabama
NPI 1053359208

Clinton Barrett Wallis is a Specialist based in Mobile, AL. Clinton Barrett Wallis practices in Mobile, AL and has the professional credentials of OT. The NPI Number for Clinton Barrett Wallis is 1053359208 and holds a License No. 2224 (Alabama).

The current practice location address for Clinton Barrett Wallis is 709 Downtowner Loop W, Mobile, AL and can be reached out via phone at 251-380-1111 and via fax at 251-380-1110.

Location: 709 Downtowner Loop W, Mobile, AL, 36609-5503
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053359208
Provider Name
Clinton Barrett Wallis
Credential
OT
Provider Entity Type
Individual
Gender
Male
Address
709 Downtowner Loop W, Mobile, AL, 36609-5503
Phone Number
251-380-1111
Fax Number
251-380-1110
Provider Enumeration Date
06/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
51514463 01 AL BCBS PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
709 Downtowner Loop W
City
Mobile
State
Alabama
Zip
36609-5503
Phone Number
251-380-1111
Fax Number
251-380-1110
person
Provider Business Mailing Address Details
Address
709 Downtowner Loop W
City
Mobile
State
Alabama
Zip
36609-5503
Phone Number
251-380-1111
Fax Number
251-380-1110
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
2224 (Alabama)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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