JACOB WALLER
Student in an Organized Health Care Education/Training Program
Active
Individual
NPI: 1295428191
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Specialist/Technologist | 235500000X | No | - |
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes | - |
Frequently Asked Questions
NPI 1295428191 is the National Provider Identifier for JACOB WALLER, a Student in an Organized Health Care Education/Training Program provider located in Moscow, ID. This NPI was enumerated on May 29, 2023.
JACOB WALLER practices at 875 PERIMETER DR, Moscow, ID 83844.
Quick Facts
- NPI
- 1295428191
- Type
- Individual
- Enumerated
- May 29, 2023
- Last Updated
- May 29, 2023
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