Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Juan Waller, PTA

Individual provider Physical Therapy Assistant · NPI 1780763425

Juan Waller, PTA is a Physical Therapy Assistant in College Park, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

1901 Phoenix Blvd Ste 205
College Park, GA 30349-5588
Phone: (770) 502-1023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA002005 (GA)

Record details

NPI number1780763425
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedNovember 3, 2006
Last updated in NPPESJuly 8, 2007
Mailing addressPo Box 518, Jonesboro, GA 30237-0518

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