Individual
THELBERT JUWON WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2124 N MAIN ST, DANVILLE, VA 24540-2725
(434) 710-6788
Mailing address
2124 N MAIN ST, DANVILLE, VA 24540-2725
(434) 710-6788
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T60714893
VA
Other
Enumeration date
07/28/2025
Last updated
07/30/2025
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