NICOLE MARIE WALLACE

VIRGINIA BEACH, VA
NPI1609089028
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy174400000X Specialist
Additional Taxonomies282NC2000X General Acute Care Hospital, Children
(Licence: VA  2305203070)
Enumeration Date2007-05-08
Last Update Date2019-03-18
Business Address
NICOLE MARIE WALLACE PT
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454-3198
Phone number: 757-550-0725
Mailing Address
NICOLE MARIE WALLACE PT
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454-3198
Phone number: 757-550-0725