Individual
MR. HUGH DURWOOD WALLER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
173 S MAIN ST, RUTLAND, VT 05701-4713
(802) 772-4165
(802) 855-8489
Mailing address
74 PLEASANT ST STE 204, NEW LONDON, NH 03257-5881
(603) 526-4635
(603) 526-2151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2008
Last updated
06/15/2021
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