WALLACE MALLERY

TROY, NY
NPI1396098703
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  239016)
Enumeration Date2012-10-23
Last Update Date2012-10-23
Business Address
-- WALLACE MALLERY
1 CONWAY CT
TROY, NY 12180-2108
Phone number: 518-274-6525
Mailing Address
-- WALLACE MALLERY
169B BOGHT RD
WATERVLIET, NY 12189-1306
Phone number: 518-274-6525