Individual
LEE ANN FULPER WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
47 DEPOT ST, CHATHAM, VA 24531-5518
(434) 432-0028
(434) 432-0062
Mailing address
415 36TH ST, SUITE 100, PARKERSBURG, WV 26101-1005
(304) 917-3660
(304) 917-3674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208101
VA
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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