Individual
ANA WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
646 SHAW RD, BROWNSVILLE, TN 38012-8730
(731) 432-0740
Mailing address
646 SHAW RD, BROWNSVILLE, TN 38012-8730
(731) 432-0740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7507
TN
Other
Enumeration date
02/10/2022
Last updated
02/11/2022
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