ELMER WALLER

KOTZEBUE, AK
NPI1013152800
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2008-12-08
Last Update Date2008-12-08
Business Address
MR. ELMER WALLER
436 5TH STREET TED STEVENS WAY
KOTZEBUE, AK 99752
Phone number: 907-442-7640
Mailing Address
MR. ELMER WALLER
436 5TH STREET TED STEVENS WAY
KOTZEBUE, AK 99752
Phone number: 907-442-7640