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1841279411
WALLACE EDWIN WILSON
CUMMING, GA
NPI
1841279411
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 4053)
Enumeration Date
2006-01-12
Last Update Date
2022-06-06
Business Address
WALLACE EDWIN WILSON PA-C
410 PEACHTREE PKWY STE 300
CUMMING, GA 30041-7407
Phone number: 404-255-1933
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Mailing Address
WALLACE EDWIN WILSON PA-C
410 PEACHTREE PKWY STE 300
CUMMING, GA 30041-7407
Phone number: 404-255-1933
Copy
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