MICHAEL WALLIS

JENNINGS, LA
NPI1285050690
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: LA  RN112816)
Enumeration Date2014-03-10
Last Update Date2020-01-26
Business Address
MICHAEL WALLIS NP
1634 ELTON RD
JENNINGS, LA 70546-3614
Phone number: 800-893-9698
Mailing Address
MICHAEL WALLIS NP
200 CORPORATE BLVD SUITE 201
LAFAYETTE, LA 70508-3870
Phone number:
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