Individual
MR. THEON WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1417 23RD AVE, MERIDIAN, MS 39301-4024
(601) 693-6626
(601) 693-6676
Mailing address
PO BOX 17167, HATTIESBURG, MS 39404-7167
(601) 261-5995
(601) 261-5335
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA227
MS
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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