MIATA WALLACE

LINCOLN, NE
NPI1013656990
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NE  2760)
Enumeration Date2022-05-31
Last Update Date2022-05-31
Business Address
MIATA WALLACE PA
1500 S 58TH ST STE 800
LINCOLN, NE 68506-1407
Phone number: 402-483-8600
Mailing Address
MIATA WALLACE PA
1500 S 58TH ST STE 800
LINCOLN, NE 68506-1407
Phone number: 402-483-8600
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