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1720014624
RAY L WALLACE
SAVANNAH, GA
NPI
1720014624
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 000935)
Enumeration Date
2006-06-23
Last Update Date
2021-02-23
Business Address
RAY L WALLACE PA
4425 PAULSEN ST
SAVANNAH, GA 31405-3662
Phone number: 912-355-6615
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Mailing Address
RAY L WALLACE PA
4425 PAULSEN ST
SAVANNAH, GA 31405-3662
Phone number: 912-355-6615
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