Individual
RICHARD R. WALLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
563 MAIN ST, BOLTON, MA 01740-1300
(978) 779-5539
(978) 779-6034
Mailing address
563 MAIN ST, BOLTON, MA 01740-1300
(978) 779-5539
(978) 779-6034
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
881
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
706089
TUFTS HEALTH PLAN
MA
01
—
WAY35658
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
10/03/2005
Last updated
08/20/2010
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