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1205666369
ANSLEY WALLACE
ATHENS, GA
NPI
1205666369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-08-05
Last Update Date
2024-08-05
Business Address
ANSLEY WALLACE
1199 PRINCE AVE
ATHENS, GA 30606-2797
Phone number: 706-475-7000
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Mailing Address
ANSLEY WALLACE
112 ROSE CREEK RD
EATONTON, GA 31024-7239
Phone number: 706-473-5303
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