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1487651386
WALLACE FORD MARTIN
LAWRENCEVILLE, GA
NPI
1487651386
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: GA 026153)
Enumeration Date
2005-07-07
Last Update Date
2010-09-01
Business Address
-- WALLACE FORD MARTIN MD
631 PROFESSIONAL DRIVE SUITE 300
LAWRENCEVILLE, GA 30046-3371
Phone number: 770-962-9977
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Mailing Address
-- WALLACE FORD MARTIN MD
631 PROFESSIONAL DRIVE SUITE 300
LAWRENCEVILLE, GA 30046-3371
Phone number: 770-962-9977
Copy
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