WALLACE FAMILY PRACTICE PA

LEHIGH ACRES, FL
NPI1063548410
Entity TypeOrganization
Authorized ContactTASHA B. WALLACE
President
239-369-2903
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
(Licence: FL  os8622)
Enumeration Date2007-02-27
Last Update Date2010-12-29
Business Address
WALLACE FAMILY PRACTICE PA
3400 LEE BLVD SUITE 108
LEHIGH ACRES, FL 33971-1309
Phone number: 239-369-2903
Mailing Address
WALLACE FAMILY PRACTICE PA
3400 LEE BLVD SUITE 108
LEHIGH ACRES, FL 33971-1309
Phone number: 239-369-2903
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