| NPI | 1982930673 |
|---|---|
| Other Name | BRENDA WALLER SOLE MEMBER |
| Entity Type | Organization |
| Authorized Contact | BRENDA SUE WALLER CEO 434-528-0896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101055485) |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2009-10-30 |