Individual
MELISSA WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
652 GABLE OAKS LN NW, CONCORD, NC 28027-5202
(704) 425-4345
Mailing address
652 GABLE OAKS LN NW, CONCORD, NC 28027-5202
(704) 425-4345
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
241108
NC
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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