MADISON WALLACE

COVINGTON, TN
NPI1740703180
Former NameMADISON JOHNSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TN  22760)
Enumeration Date2017-07-18
Last Update Date2024-04-17
Business Address
MADISON WALLACE APN
1995 HIGHWAY 51 S STE 204
COVINGTON, TN 38019-3655
Phone number: 901-475-5305
Mailing Address
MADISON WALLACE APN
965 RIDGE LAKE BLVD STE 315
MEMPHIS, TN 38120-9401
Phone number: 901-227-7015
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