CARLY WALLACE

AUGUSTA, GA
NPI1700562766
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: GA  15182)
Enumeration Date2023-06-26
Last Update Date2024-12-02
Business Address
CARLY WALLACE DO
1120 15TH STREET BI5070
AUGUSTA, GA 30912
Phone number: 706-721-2423
Mailing Address
CARLY WALLACE DO
1120 15TH STREET BI5070
AUGUSTA, GA 30912
Phone number: 706-721-2423
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