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1396098703
WALLACE MALLERY
TROY, NY
NPI
1396098703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 239016)
Enumeration Date
2012-10-23
Last Update Date
2012-10-23
Business Address
-- WALLACE MALLERY
1 CONWAY CT
TROY, NY 12180-2108
Phone number: 518-274-6525
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Mailing Address
-- WALLACE MALLERY
169B BOGHT RD
WATERVLIET, NY 12189-1306
Phone number: 518-274-6525
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