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1932807773
KYLE ANTHONY WALLER
CULVER CITY, CA
NPI
1932807773
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
225400000X Rehabilitation Practitioner
Enumeration Date
2023-02-21
Last Update Date
2023-06-20
Business Address
KYLE ANTHONY WALLER
9808 VENICE BLVD STE 505
CULVER CITY, CA 90232-6818
Phone number: 310-945-3350
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Mailing Address
KYLE ANTHONY WALLER
9808 VENICE BLVD STE 505
CULVER CITY, CA 90232-6818
Phone number: 310-945-3350
Copy
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