Individual
CARLY WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18600 WEDGE PKWY, RENO, NV 89511-3036
(775) 283-8461
Mailing address
235 TERRACE ST, ASHLAND, OR 97520-2834
(775) 283-8461
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NV
Other
Enumeration date
05/22/2023
Last updated
11/06/2024
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