Individual
JAMIE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
723 BEREA AVE, GADSDEN, AL 35901-4155
(256) 312-8988
Mailing address
1303 BELLEVUE DR, GADSDEN, AL 35904-3622
(256) 295-8889
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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