SUSAN R WALLACE

HATTIESBURG, MS
NPI1740537687
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  R852101)
Enumeration Date2012-08-09
Last Update Date2012-08-10
Business Address
-- SUSAN R WALLACE
100 METHODIST BLVD
HATTIESBURG, MS 39402-1295
Phone number: 601-268-6738
Mailing Address
-- SUSAN R WALLACE
100 METHODIST BLVD
HATTIESBURG, MS 39402-1295
Phone number: 601-268-6738
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