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1730871567
THOMAS JEFFREY WALLACE
WEST COLUMBIA, SC
NPI
1730871567
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-05-22
Last Update Date
2024-08-23
Business Address
THOMAS JEFFREY WALLACE DO
145 SUNSET CT STE 100
WEST COLUMBIA, SC 29169-2429
Phone number: 803-739-3491
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Mailing Address
THOMAS JEFFREY WALLACE DO
145 SUNSET CT STE 100
WEST COLUMBIA, SC 29169-2429
Phone number: 803-739-3491
Copy
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