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1851084966
JOHN NELL WALLACE
SANTA ROSA, CA
NPI
1851084966
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2023-06-02
Last Update Date
2023-06-02
Business Address
JOHN NELL WALLACE
1430 NEOTOMAS AVE
SANTA ROSA, CA 95405-7575
Phone number: 707-565-7460
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Mailing Address
JOHN NELL WALLACE
1430 NEOTOMAS AVE
SANTA ROSA, CA 95405-7575
Phone number: 707-565-7460
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