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1275945354
THOMAS WALLACE
VISALIA, CA
NPI
1275945354
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-05-23
Last Update Date
2016-03-07
Business Address
-- THOMAS WALLACE
1646 S COURT ST
VISALIA, CA 93277-4962
Phone number: 559-625-8890
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Mailing Address
-- THOMAS WALLACE
1646 S COURT ST
VISALIA, CA 93277-4962
Phone number: 559-625-8890
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