Organization
WALLER ANESTHESIA SERVICES LLC
Active
Other names
The Body Emporium Aesthetics and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE MARIE WALLER CRNA APNP (OWNER)
(708) 275-7914
Entity
Organization
Contact information
Practice address
55 W SCOTT ST, FOND DU LAC, WI 54935-2342
(708) 275-7914
(408) 698-8411
Mailing address
27 WHISPERING SPRINGS CT, FOND DU LAC, WI 54937-6912
(708) 275-7914
(408) 698-8411
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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