Waller, Mark

Waller, Mark is an individual health care provider with primary practice located at 11742 Eros Rd , Lehigh Acres FL 33971-3759. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Waller, Mark can be contacted via phone (239) 671-8962.

Contact Information

Primary practice address
11742 Eros Rd Lehigh Acres FL 33971-3759
Phone: (239) 671-8962
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 16250 Florida

Profile Details

NPI number 1801525381
LBN Legal business name Waller, Mark
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2022
Last updated Jun 9th, 2022 - about 3 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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