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Dominique Waller
NPI 1790529568 · on the registry since 2024
Practice
- Address
- 214 Westside Blvd
Apt. 6
Roanoke, VA 24017 - Phone
- (540) 278-9002
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-06-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia