Individual
KACI WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-AA
Contact information
Practice address
2637 ARBOR GLEN PL, MARIETTA, GA 30066-4274
(229) 589-7427
Mailing address
2637 ARBOR GLEN PL, MARIETTA, GA 30066-4274
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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