Individual provider · Type 1 NPI

Lisa M. Waller, PAC

Medical Physician Assistant · Atlanta, GA

NPI number 1851325831 Active

Practice location

1100 Lake Hearn Drive, Ste #450
Atlanta, GA 30342

Call (404) 252-7339 Map

Fax (404) 257-0337

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X004516 (NH)

Medical Physician Assistant: Definition to come...

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About NPI 1851325831

Lisa M. Waller, PAC's National Provider Identifier is 1851325831, issued on Jul 10, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Atlanta, GA. The record was last updated on Jul 8, 2007.