SHANE WALLIN

SAN DIEGO, CA
NPI1104282177
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy246ZA2600X Specialist/Technologist, Other Art, Medical
(Licence: MN  310143)
Enumeration Date2016-01-06
Last Update Date2019-08-07
Business Address
SHANE WALLIN
1968 GARNET AVE
SAN DIEGO, CA 92109-3555
Phone number: 612-214-1325
Mailing Address
SHANE WALLIN
3116 MOONEY ST
SAN DIEGO, CA 92117-6137
Phone number: 619-942-9737
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