HEATH WADE WALLACE

FPO, AE
NPI1558323725
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2006-04-04
Last Update Date2008-04-20
Business Address
Mr. HEATH WADE WALLACE IDC
USS THEODORE ROOSEVELT CVN 71 MEDICAL DEPARTMENT
FPO, AE 09599 2871
Phone number: 757-445-6230
Mailing Address
Mr. HEATH WADE WALLACE IDC
1973 BIG BOULDER DR
VIRGINIA BEACH, VA 23456-6126
Phone number: 757-471-1746
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