Individual
MISS LEAH WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1985 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-6233
(540) 373-6647
Mailing address
1985 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-6233
(540) 373-6647
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/07/2015
Last updated
01/23/2020
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