ADAM WALLER

WEST FRANKFORT, IL
NPI1508476615
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209021745)
Enumeration Date2020-08-04
Last Update Date2022-05-23
Business Address
ADAM WALLER NP
502 W SAINT LOUIS ST STE 4
WEST FRANKFORT, IL 62896-1968
Phone number: 618-937-3400
Mailing Address
ADAM WALLER NP
PO BOX 3988
CARBONDALE, IL 62902-3988
Phone number: 618-937-3400