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1720668551
WILLIAM J WALLACH
TAMPA, FL
NPI
1720668551
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-14
Last Update Date
2021-04-14
Business Address
WILLIAM J WALLACH
12901 BRUCE B DOWNS BLVD UNIT 715
TAMPA, FL 33612-4799
Phone number: 813-396-9459
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Mailing Address
WILLIAM J WALLACH
12901 BRUCE B DOWNS BLVD UNIT 715
TAMPA, FL 33612-4742
Phone number: 813-396-0075
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