Organization
CLINICAL CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DARRA M WALLER BA, MA (PRESIDENT)
(678) 516-1424
Entity
Organization
Contact information
Practice address
410 CRESTWORTH XING, POWDER SPRINGS, GA 30127-5739
(678) 516-1424
Mailing address
410 CRESTWORTH XING, POWDER SPRINGS, GA 30127-5739
(678) 516-1424
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHI-012266
GA
Other
Enumeration date
07/24/2007
Last updated
06/17/2008
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