Organization
PRIS, PLC
Active
Organization
PRIS, PLC
Active
Other names
Brenda Waller Sole Member
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA SUE WALLER MD (CEO)
(434) 528-0896
Entity
Organization
Contact information
Practice address
1935 THOMSON DR, LYNCHBURG, VA 24501-1008
(434) 528-0896
(434) 528-0898
Mailing address
1935 THOMSON DR, LYNCHBURG, VA 24501-1008
(434) 528-0896
(434) 528-0898
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101055485
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010045100
—
VA
Enumeration date
10/30/2009
Last updated
10/30/2009
Update your record
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