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1225482946
LAUREL SLOUGH WALLACE
MIDLOTHIAN, VA
NPI
1225482946
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Former Name
LAUREL SLOUGH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NC 218358)
Enumeration Date
2016-04-19
Last Update Date
2021-11-05
Business Address
LAUREL SLOUGH WALLACE D.O.
13540 HULL STREET RD
MIDLOTHIAN, VA 23112-2107
Phone number: 804-739-6142
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Mailing Address
LAUREL SLOUGH WALLACE D.O.
13540 HULL STREET RD
MIDLOTHIAN, VA 23112-2107
Phone number: 804-739-6142
Copy
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