PAUL DAVID WALLACE

STOCKTON, CA
NPI1114044799
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy167G00000X Licensed Psychiatric Technician
(Licence: CA  PT 26296)
Enumeration Date2007-03-26
Last Update Date2007-07-08
Business Address
Mr. PAUL DAVID WALLACE
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-3760
Mailing Address
Mr. PAUL DAVID WALLACE
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-3760
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