Individual
MR. MELVIN JOE WALLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2200 SW GAGE BLVD, TOPEKA, KS 66622-0001
(785) 350-3111
(785) 350-4541
Mailing address
3245 NW ACORN PL, TOPEKA, KS 66618-1553
(785) 286-2928
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
54716
KS
Other
Enumeration date
06/16/2006
Last updated
07/08/2007
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