Individual
PAUL WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13254 MONDOVI DR, FRISCO, TX 75033-0944
(817) 360-5181
Mailing address
13254 MONDOVI DR, FRISCO, TX 75033-0944
(817) 360-5181
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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