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Individual
JOSEPH R. WALLER
Active
Individual
JOSEPH R. WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6231-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27F99WA
BCBS OF MN
MN
05
—
40319100
—
WI
01
—
42B57WA
BCBS OF MN
MN
01
—
64-03552
MEDICA
WI
01
—
64-07247
MEDICA
WI
01
—
650023250
RAILROAD MEDICARE/POPLAR
WI
01
—
84251
SECURITY HEALTH PLAN
WI
01
—
P00403685
RAILROAD MEDICARE/NEW LONDON
WI
Enumeration date
06/16/2006
Last updated
06/27/2013
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