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1013262435
LEIGH E. WALLACE IVY
BIRMINGHAM, AL
NPI
1013262435
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Former Name
LEIGH E. WALLACE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-093252)
Enumeration Date
2012-07-23
Last Update Date
2017-11-06
Business Address
LEIGH E. WALLACE IVY CRNA
810 SAINT VINCENTS DR
BIRMINGHAM, AL 35205-1601
Phone number: 205-939-7143
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Mailing Address
LEIGH E. WALLACE IVY CRNA
PO BOX 55310
BIRMINGHAM, AL 35255-5310
Phone number: 205-731-9701
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