LISA MARIE WALLACE

MACON, GA
NPI1548439375
Other NameLISA MARIE CAMPBELL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: AL  1-097840)
Enumeration Date2008-02-26
Last Update Date2015-06-05
Business Address
-- LISA MARIE WALLACE CRNA
777 HEMLOCK ST
MACON, GA 31201-2102
Phone number: 478-633-1000
Mailing Address
-- LISA MARIE WALLACE CRNA
598 3RD ST
MACON, GA 31201-3357
Phone number: 478-633-6706