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Contact Information

GARY WALLER, ATC
6220 1 AND A HALF HALF MILE ROAD
STERLING HEIGHTS, MI48314
 Phone: 586-731-6603
 Fax: 586-731-1148
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for GARY WALLER · (Male)

NPI # 1568505592
Status Active
Credentials ATC
Entity Individual
Enumeration date 02/15/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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