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1811169451
SAM LOC WALLACE
FAYETTEVILLE, AR
NPI
1811169451
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: AR P0702007)
Enumeration Date
2008-03-24
Last Update Date
2015-04-08
Business Address
MR. SAM LOC WALLACE L.P.C.
1845 N GREEN ACRES RD
FAYETTEVILLE, AR 72703-2615
Phone number: 479-957-8546
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Mailing Address
MR. SAM LOC WALLACE L.P.C.
1845 N GREEN ACRES RD
FAYETTEVILLE, AR 72703-2615
Phone number: 479-957-8546
Copy
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