Provider Demographics
NPI:1477762607
Name:MONROE VETERINARY CLINIC INC
Entity Type:Organization
Organization Name:MONROE VETERINARY CLINIC INC
Other - Org Name:THOMAS HENRY WALL DVM
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:770-267-3690
Mailing Address - Street 1:1016 EAST SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655
Mailing Address - Country:US
Mailing Address - Phone:770-267-3690
Mailing Address - Fax:770-267-0761
Practice Address - Street 1:1016 EAST SPRING ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655
Practice Address - Country:US
Practice Address - Phone:770-267-3690
Practice Address - Fax:770-267-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1699174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Multi-Specialty