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1053622167
HOLLI DEZAUN WALLER
BLACKSBURG, VA
NPI
1053622167
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Former Name
HOLLI DEZAUN HOLMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: VA 0116022785)
Enumeration Date
2010-06-24
Last Update Date
2010-06-24
Business Address
Mrs. HOLLI DEZAUN WALLER D.O.
3700 SOUTH MAIN STREET
BLACKSBURG, VA 24060
Phone number: 540-953-5445
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Mailing Address
Mrs. HOLLI DEZAUN WALLER D.O.
6326 STONEWOOD POINTE LN.
HOUSTON, TX 77066
Phone number: 281-300-9849
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