MICAH R WALLACE

LATROBE, PA
NPI1588946214
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: PA  MA054581)
Enumeration Date2011-09-20
Last Update Date2018-12-21
Business Address
Ms. MICAH R WALLACE PA-C
100 EXCELA HEALTH DR STE 102
LATROBE, PA 15650-9001
Phone number: 724-804-1760
Mailing Address
Ms. MICAH R WALLACE PA-C
520 JEFFERSON AVE SUITE 400
JEANNETTE, PA 15644-2538
Phone number: 724-527-8060