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1679047005
LAURA J WALLACE
STOCKBRIDGE, GA
NPI
1679047005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367A00000X Advanced Practice Midwife
(Licence: GA RN067198)
Enumeration Date
2019-01-18
Last Update Date
2019-01-18
Business Address
LAURA J WALLACE CNM
115 EAGLE SPRING DR STE A200
STOCKBRIDGE, GA 30281-6486
Phone number: 770-474-0064
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Mailing Address
LAURA J WALLACE CNM
115 EAGLE SPRING DR STE A200
STOCKBRIDGE, GA 30281-6486
Phone number: 770-474-0064
Copy
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