ROBERT WALLACE

JACKSON, TN
NPI1003950288
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TN  53447)
Enumeration Date2007-02-19
Last Update Date2011-11-04
Business Address
-- ROBERT WALLACE CRNA
367 HOSPITAL BLVD
JACKSON, TN 38305-2080
Phone number: 731-661-2227
Mailing Address
-- ROBERT WALLACE CRNA
367 HOSPITAL BLVD
JACKSON, TN 38305-2080
Phone number: 731-661-2227
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