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1164004420
TINA WALLACE
BIRMINGHAM, AL
NPI
1164004420
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251F00000X Home Infusion
Enumeration Date
2021-04-26
Last Update Date
2021-04-26
Business Address
TINA WALLACE
2408 CARSON RD UNIT 1
BIRMINGHAM, AL 35215-3102
Phone number: 205-757-0249
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Mailing Address
TINA WALLACE
725 SUNHILL RD NW APT H
CENTER POINT, AL 35215-3043
Phone number: 205-757-0249
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