Organization
J GREGORY WALLER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDY BECK (MANAGER)
(706) 745-6764
Entity
Organization
Contact information
Practice address
602 PAT HARALSON DRIVE, BLAIRSVILLE, GA 30512
(706) 745-6764
Mailing address
602 PAT HARALSON DR, BLAIRSVILLE, GA 30512-8414
(706) 745-6764
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000746
GA
Other
Enumeration date
03/24/2008
Last updated
07/17/2013
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