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Individual

MR. DANIEL P. WALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LOTR

Contact information

Practice address
2101 ROBIN AVE STE 4, HAMMOND, LA 70403-5774
(985) 230-6160
(985) 230-6248
Mailing address
40080 N RATEAU RD, PONCHATOULA, LA 70454-8822

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200844
LA

Other

Enumeration date
03/18/2016
Last updated
03/18/2016
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