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1578796926
JENNIFER KATHERINE WALLACE
VENTURA, CA
NPI
1578796926
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: CA PA20925)
Enumeration Date
2009-09-02
Last Update Date
2010-09-08
Business Address
-- JENNIFER KATHERINE WALLACE PA-C
2660 E MAIN ST SUITE 204
VENTURA, CA 93003-2893
Phone number: 805-643-7500
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Mailing Address
-- JENNIFER KATHERINE WALLACE PA-C
2660 E MAIN ST SUITE 204
VENTURA, CA 93003-2893
Phone number: 805-643-7500
Copy
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