RICHARD PETERKIN WALLACE

CLEARWATER, FL
NPI1275586448
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  ME85690)
Additional Taxonomies207QS0010X Family Medicine, Sports Medicine
(Licence: FL  ME85690)
Enumeration Date2006-05-18
Last Update Date2016-09-27
Business Address
Dr. RICHARD PETERKIN WALLACE M.D.
1001 S FORT HARRISON AVE SUITE 101
CLEARWATER, FL 33756-3941
Phone number: 727-441-5044
Mailing Address
Dr. RICHARD PETERKIN WALLACE M.D.
1001 S FORT HARRISON AVE SUITE 101
CLEARWATER, FL 33756-3905
Phone number: 727-441-5044