RICKY WALLACE

JACKSONVILLE, FL
NPI1538455142
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
Enumeration Date2011-06-22
Last Update Date2011-06-22
Business Address
-- RICKY WALLACE
10512 INNISBROOK DRIVE
JACKSONVILLE, FL 32222
Phone number: 904-534-4937
Mailing Address
-- RICKY WALLACE
10512 INNISBROOK DR
JACKSONVILLE, FL 32222-1363
Phone number: 904-534-4937
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