ERIC WALLACE

SHREVEPORT, LA
NPI1780372904
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-04-26
Last Update Date2023-06-13
Business Address
ERIC WALLACE
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-6483
Mailing Address
ERIC WALLACE
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number:
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