ISSAIAH WALLACE

WESTON, WV
NPI1508422338
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WV  102650)
Enumeration Date2019-05-16
Last Update Date2025-09-22
Business Address
ISSAIAH WALLACE PMHNP
936 SHARPE HOSPITAL RD
WESTON, WV 26452-8550
Phone number: 304-269-1210
Mailing Address
ISSAIAH WALLACE PMHNP
PO BOX 12
ENTERPRISE, WV 26568-0012
Phone number: 304-709-8420
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