Juan Waller, PTA
NPI #1780763425 in College Park, Georgia
Provider Information
- NPI Number
- 1780763425
- Entity Type
- Individual
- Name
- Juan Waller, PTA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Nov 3, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1901 PHOENIX BLVD
- Address 2
- SUITE 205
- City
- College Park
- State
- Georgia
- ZIP Code
- 30349-5588
- Phone
- (770) 502-1023
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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