MR. Christopher Scott Waller, IDC

NPI #1871850321 in Fallon, Nevada

Provider Information

NPI Number: 1871850321
Entity Type: Individual
Name: MR. Christopher Scott Waller, IDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: IDC
Enumeration Date: Apr 20, 2012
Last Updated: Mar 12, 2024

Practice Location

Address: 4755 PASTURE RD BLDG 299
City: Fallon
State: Nevada
ZIP Code: 89496-3202
Phone: (775) 426-3125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman	1710I1002X
Physician Assistant	363A00000X	Primary

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