MINDA WALLACE

ORMOND BEACH, FL
NPI1164809901
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  9108697)
Enumeration Date2015-04-30
Last Update Date2015-04-30
Business Address
-- MINDA WALLACE PA-C
298 S YONGE ST
ORMOND BEACH, FL 32174-6264
Phone number: 386-274-7840
Mailing Address
-- MINDA WALLACE PA-C
298 S YONGE ST
ORMOND BEACH, FL 32174-6264
Phone number:
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