Provider Demographics
NPI:1891584835
Name:WALL, SYLER AUSTIN
Entity type:Individual
Prefix:
First Name:SYLER
Middle Name:AUSTIN
Last Name:WALL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11661 MUNZ LN
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53821-9500
Mailing Address - Country:US
Mailing Address - Phone:608-379-4453
Mailing Address - Fax:
Practice Address - Street 1:2575 7TH ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-5249
Practice Address - Country:US
Practice Address - Phone:608-406-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant