Individual
CHRISTINA MARIE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
445028 E SPORTSMAN LN, VINITA, OK 74301-7177
(918) 734-4252
Mailing address
445028 E SPORTSMAN LN, VINITA, OK 74301-7177
(918) 734-4252
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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