Individual
MR. WILLIAM L WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BOCO, CPED, CO,OPA-C
Contact information
Practice address
110 OSIGIAN BLVD, WARNER ROBINS, GA 31088-7880
(478) 953-2922
(478) 953-2927
Mailing address
403 COMMERCE ST W, PINEVIEW, GA 31071-3145
(229) 624-2723
(478) 953-2927
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
000009
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009
STATE LICENSED ORTHOTIST
GA
01
—
1895
CERTIFIED PEDORTHIST
GA
01
—
681
ORTHOPEDIC PHYS ASSISTANT
GA
01
—
714
PARAMEDIC
GA
01
—
C15148
BOC CERTIFIED ORTHOTIST
GA
01
—
CO3593
ABC CERTIFIED ORTHOTIST
GA
Enumeration date
12/04/2006
Last updated
07/08/2007
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