MELISSA B WALLACE

SAINT LOUIS, MO
NPI1497027247
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MO  151045)
Enumeration Date2012-02-08
Last Update Date2018-01-29
Business Address
Mrs. MELISSA B WALLACE WHNP
4901 FOREST PARK AVE STE 710 STE 710
SAINT LOUIS, MO 63108-1402
Phone number: 314-362-4211
Mailing Address
Mrs. MELISSA B WALLACE WHNP
660 S EUCLID AVE C B 8064
SAINT LOUIS, MO 63110-1010
Phone number: 314-747-0800