Individual
CHRISTOPHER DREW WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18586 ROUTE 52, FORT GAY, WV 25514-7046
(304) 617-2242
Mailing address
18586 ROUTE 52, FORT GAY, WV 25514-7046
(304) 617-2242
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017245
KY
183500000X
Pharmacist
03234139
OH
Other
Enumeration date
04/23/2013
Last updated
09/15/2014
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