Waller, Kenneth Russell

Waller, Kenneth Russell is an individual health care provider with primary practice located at 2015 Linden Dr Room 2058, Madison WI 53706-1100. He recently has only one registered license in Other Service Providers / Veterinarian, which is considered as his primary health care specialty. Waller, Kenneth Russell can be contacted via phone (608) 263-7656.

Contact Information

Primary practice address
2015 Linden Dr Room 2058 Madison WI 53706-1100
Phone: (608) 263-7656
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Veterinarian 174M00000X 6054 Wisconsin
Other Service Providers / Veterinarian 174M00000X 7379 Iowa
Other Service Providers / Veterinarian 174M00000X 090010797 Illinois

Profile Details

NPI number 1841546959
LBN Legal business name Waller, Kenneth Russell
Credentials DVM, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2012
Last updated Jul 25th, 2012 - 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.

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