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1720306558
TRACY WALLACE
GONZALES, LA
NPI
1720306558
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: LA 204717)
Enumeration Date
2010-05-04
Last Update Date
2021-05-19
Business Address
TRACY WALLACE MD
1937 S BURNSIDE AVE
GONZALES, LA 70737-4632
Phone number: 225-765-5500
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Mailing Address
TRACY WALLACE MD
5959 S SHERWOOD FOREST BLVD
BATON ROUGE, LA 70816-6038
Phone number: 225-765-5727
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