SCOTT DAVID WALLACE

FAIRFIELD, CA
NPI1790442408
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  459083)
Enumeration Date2021-11-17
Last Update Date2021-11-17
Business Address
SCOTT DAVID WALLACE NP
513 SILVERADO CIR
FAIRFIELD, CA 94534-6818
Phone number: 707-864-3240
Mailing Address
SCOTT DAVID WALLACE NP
513 SILVERADO CIR
FAIRFIELD, CA 94534-6818
Phone number: 707-864-3240
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