Individual
DR. BENJAMIN LANE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2560 KING ARTHUR BLVD STE 120, LEWISVILLE, TX 75056-5818
(972) 899-9737
(972) 899-9738
Mailing address
2560 KING ARTHUR BLVD STE 120, LEWISVILLE, TX 75056-5818
(972) 899-9737
(972) 899-9738
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15693
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15693
STATE LICENSE
TX
Enumeration date
07/25/2023
Last updated
07/25/2023
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