LIZABETH WALLACE

PEORIA, IL
NPI1417019084
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  0411285741-209004409)
Enumeration Date2006-12-13
Last Update Date2009-04-20
Business Address
-- LIZABETH WALLACE
420 NE GLEN OAK AVE
PEORIA, IL 61603-3105
Phone number: 309-655-2343
Mailing Address
-- LIZABETH WALLACE
420 NE GLEN OAK AVE
PEORIA, IL 61603-3105
Phone number: 309-655-2343
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