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1568531416
JESSE WALLACE
LENOIR, NC
NPI
1568531416
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: KY 19466)
Enumeration Date
2006-11-07
Last Update Date
2019-06-06
Business Address
JESSE WALLACE M.D.
1138 WATERFALL LN
LENOIR, NC 28645-8943
Phone number: 702-102-7922
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Mailing Address
JESSE WALLACE M.D.
1138 WATERFALL LN
LENOIR, NC 28645-8943
Phone number: 702-102-7922
Copy
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