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1730563982
TONYA RENEE WALLACE
DECATUR, GA
NPI
1730563982
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN161712)
Enumeration Date
2015-07-17
Last Update Date
2015-07-17
Business Address
-- TONYA RENEE WALLACE FNP
2701 N DECATUR RD
DECATUR, GA 30033-5918
Phone number: 404-501-1000
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Mailing Address
-- TONYA RENEE WALLACE FNP
189 EDISON DRIVE
STOCKBRIDGE, GA 30281-2761
Phone number: 678-471-9400
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