EMERSON AKALEE WALLACE

SALTILLO, MS
NPI1336251560
Entity TypeIndividual
GenderN/A
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  R759298)
Enumeration Date2006-09-01
Last Update Date2007-07-08
Business Address
Mr. EMERSON AKALEE WALLACE CFNP
1154 CROSS CREEK DR
SALTILLO, MS 38866-5777
Phone number: 662-840-8010
Mailing Address
Mr. EMERSON AKALEE WALLACE CFNP
118 CR1810
SALTILLO, MS 38866
Phone number: 662-844-6596