Waller, Eulanda Lara

Waller, Eulanda Lara is an sole proprietor health care provider with primary practice located at 315 Christina Ct , Macon GA 31217-4528. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Waller, Eulanda Lara can be contacted via phone (478) 318-2313.

Contact Information

Primary practice address
315 Christina Ct Macon GA 31217-4528
Fax: (478) 755-0335
Website:

Health care specialties

Profile Details

NPI number 1073759619
LBN Legal business name Waller, Eulanda Lara
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2009
Last updated Feb 28th, 2013 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073759619 NPPES
Georgia MEDICAID 874780070A

Popular Providers