Individual
MR. DAVID LOUIS WALLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
60 TOWNSHIP LINE RD, ELKINS PARK, PA 19027-2220
(215) 663-6800
(215) 663-6547
Mailing address
7435 ELIZABETH RD, ELKINS PARK, PA 19027-3322
(215) 782-2223
(215) 782-1066
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA001013L
PA
Other
Enumeration date
05/03/2009
Last updated
05/03/2009
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