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1467001180
JOHN WALLER
LOUISA, KY
NPI
1467001180
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2019-09-05
Last Update Date
2019-09-05
Business Address
JOHN WALLER
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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Mailing Address
JOHN WALLER
PO BOX 726
LOUISA, KY 41230-0726
Phone number:
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