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Contact Information

DEANNA L WALLER, P.T.A.
500 GRAND PLAZA
ORANGE CITY, FL32763
 Phone: 386-775-0855
 Fax: 386-775-0855
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for DEANNA L WALLER · (Female)

NPI # 1588787360
Status Active
Credentials P.T.A.
Entity Individual
Enumeration date 04/09/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # PTA19131
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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