Waller, Justin Blaine

Waller, Justin Blaine is an sole proprietor health care provider with primary practice located at 3468 Nw Federal Hwy , Jensen Beach FL 34957-4440. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Waller, Justin Blaine can be contacted via phone (772) 692-2020.

Contact Information

Primary practice address
3468 Nw Federal Hwy Jensen Beach FL 34957-4440
Phone: (772) 692-2020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC5725 Florida

Profile Details

NPI number 1780239640
LBN Legal business name Waller, Justin Blaine
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 7th, 2019
Last updated Aug 7th, 2019 - about 5 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.

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