Waller, Diane
Waller, Diane is an individual health care provider with primary practice located at 4500 S Lancaster Rd , Dallas TX 75216-7167. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Kinesiotherapist, which is considered as her primary health care specialty. Waller, Diane can be contacted via phone (817) 385-5949.Contact Information
Primary practice address
4500 S Lancaster Rd
Dallas TX 75216-7167
Phone: (817) 385-5949
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Kinesiotherapist | 226300000X | 1383 |
Profile Details
| NPI number | 1982628970 |
|---|---|
| LBN Legal business name | Waller, Diane |
| Credentials | RKT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Oct 9th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982628970 | NPPES |
| Other | 1383 | COPSKT |
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