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1346004900
JEREMY JOEL WALLACE
OAK RIDGE, TN
NPI
1346004900
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2024-02-13
Last Update Date
2024-02-13
Business Address
JEREMY JOEL WALLACE BA
100 ADAMS LN
OAK RIDGE, TN 37830-4909
Phone number: 865-483-7743
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Mailing Address
JEREMY JOEL WALLACE BA
200 TECH CENTER DR
KNOXVILLE, TN 37912-2747
Phone number: 865-637-9711
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