BRIANNA M WALLACE

NEWARK, DE
NPI1184486235
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: DE  C5-0012199)
Additional Taxonomies363A00000X Physician Assistant
(Licence: MD  C0009759)
Enumeration Date2024-01-24
Last Update Date2025-01-13
Business Address
BRIANNA M WALLACE PA-C
4755 OGLETOWN STANTON ROAD SUITE 5A43
NEWARK, DE 19718-2200
Phone number: 302-623-0188
Mailing Address
BRIANNA M WALLACE PA-C
817 VIRGINIA AVE
DEPTFORD, NJ 08096-5337
Phone number: 856-371-4415