KILAR WALLACE

SAN DIEGO, CA
NPI1508658139
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2025-05-20
Last Update Date2025-05-20
Business Address
KILAR WALLACE
34800 BOB WILSON DR
SAN DIEGO, CA 92134-1098
Phone number: 570-665-1814
Mailing Address
KILAR WALLACE
5550 SURF RIDER WAY APT 133
SAN DIEGO, CA 92154-6528
Phone number: 570-665-1814
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