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1407317472
KYRSTEN WALLACE
SYRACUSE, NY
NPI
1407317472
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NY 318197)
Enumeration Date
2019-03-30
Last Update Date
2022-12-13
Business Address
KYRSTEN WALLACE MD
750 E ADAMS ST
SYRACUSE, NY 13210-2306
Phone number: 315-464-8948
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Mailing Address
KYRSTEN WALLACE MD
4900 BROAD RD STE 3M
SYRACUSE, NY 13215-2265
Phone number:
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