LAURY M WALLACE

WESTFIELD, IN
NPI1205343845
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207QA0505X Family Medicine, Adult Medicine
(Licence: IN  71007724A)
Additional Taxonomies207QA0000X Family Medicine, Adolescent Medicine
(Licence: IN  71007724A)
207QG0300X Family Medicine, Geriatric Medicine
(Licence: IN  71007724A)
207QH0002X Family Medicine, Hospice and Palliative Medicine
(Licence: IN  71007724A)
Enumeration Date2018-01-04
Last Update Date2018-01-04
Business Address
LAURY M WALLACE NP
16731 GAITHER BLVD
WESTFIELD, IN 46074-4607
Phone number: 317-561-6840
Mailing Address
LAURY M WALLACE NP
16731 GAITHER BLVD
WESTFIELD, IN 46074-4421
Phone number: 812-239-3771