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1962873711
LEAH M WALLER
VIDALIA, GA
NPI
1962873711
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Former Name
LEAH M MEADOWS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: GA 007734)
Enumeration Date
2015-10-19
Last Update Date
2019-10-17
Business Address
LEAH M WALLER PA
1 MEADOWS PKWY
VIDALIA, GA 30474-8759
Phone number: 912-535-5800
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Mailing Address
LEAH M WALLER PA
PO BOX 407
VIDALIA, GA 30475-0407
Phone number: 912-537-4986
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