Individual
JUSTIN WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1501 TATE BLVD SE, HICKORY, NC 28602-1384
(828) 304-0400
Mailing address
1501 TATE BLVD SE, HICKORY, NC 28602-1384
(803) 320-9070
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
852
NC
Other
Enumeration date
04/01/2022
Last updated
05/22/2025
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