KELLIE L WALLACE-WILDING

JACKSON, TN
NPI1063518629
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: TN  41583)
Enumeration Date2006-09-14
Last Update Date2012-11-29
Business Address
-- KELLIE L WALLACE-WILDING MD
2863 HIGHWAY 45 BYP
JACKSON, TN 38305-3618
Phone number: 731-664-1375
Mailing Address
-- KELLIE L WALLACE-WILDING MD
PO BOX 400
JACKSON, TN 38302-0400
Phone number: 731-423-8697
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