DUSTIN W WALLACE

BIRMINGHAM, AL
NPI1275906158
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: AL  1-133041)
Enumeration Date2015-11-02
Last Update Date2015-11-02
Business Address
-- DUSTIN W WALLACE CRNP
833 PRINCETON AVE SW POB III; SUITE 200A
BIRMINGHAM, AL 35211-1323
Phone number: 205-786-2776
Mailing Address
-- DUSTIN W WALLACE CRNP
833 PRINCETON AVE SW POB III; SUITE 200A
BIRMINGHAM, AL 35211-1323
Phone number:
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