Individual
MICHAEL WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
12312 W DONGES BAY RD, MEQUON, WI 53097-3312
(262) 455-6300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12640-24
WI
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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