TYLER J WALLACE

PADUCAH, KY
NPI1114700739
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: KY  4005513)
Enumeration Date2023-08-16
Last Update Date2024-11-14
Business Address
TYLER J WALLACE PMHNP-BC
1532 LONE OAK RD STE 345
PADUCAH, KY 42003-7942
Phone number: 270-444-2250
Mailing Address
TYLER J WALLACE PMHNP-BC
1532 LONE OAK RD STE 345
PADUCAH, KY 42003-7942
Phone number: 270-444-2250
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