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1508010638
KATHLEEN WALLACE
BOSTON, MA
NPI
1508010638
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MA 258192)
Enumeration Date
2008-11-17
Last Update Date
2008-11-17
Business Address
-- KATHLEEN WALLACE NP
300 LONGWOOD AVE
BOSTON, MA 02115-5724
Phone number: 617-355-8117
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Mailing Address
-- KATHLEEN WALLACE NP
244 BUNKER HILL STREET
CHARLESTOWN, MA 02129
Phone number: 617-512-5297
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