TYLER J WALLACE

PADUCAH, KY
NPI1114700739
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: KY  4005513)
Enumeration Date2023-08-16
Last Update Date2023-08-16
Business Address
TYLER J WALLACE PMHNP-BC
4570 PECAN DR STE C
PADUCAH, KY 42001-6717
Phone number: 270-908-3839
Mailing Address
TYLER J WALLACE PMHNP-BC
4570 PECAN DR STE C
PADUCAH, KY 42001-6717
Phone number: 270-908-3839
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