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1437149739
TIMOTHY R WALLACE
BOSTON, MA
NPI
1437149739
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103T00000X Psychologist
(Licence: MA 4282)
Enumeration Date
2005-10-27
Last Update Date
2007-07-08
Business Address
Dr. TIMOTHY R WALLACE PHD
125 NASHUA STREET SPAULDING REHAB HOSPITAL
BOSTON, MA 02114-1198
Phone number: 617-573-2694
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Mailing Address
Dr. TIMOTHY R WALLACE PHD
PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
CHARLESTOWN, MA 02129-9142
Phone number: 617-724-0287
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