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
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