MARYSA P WALLACE

FAYETTEVILLE, GA
NPI1932989357
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN259981)
Enumeration Date2023-10-03
Last Update Date2024-08-14
Business Address
MARYSA P WALLACE AGNP-C
132 OLD NORTON RD STE 200
FAYETTEVILLE, GA 30215-4873
Phone number: 678-817-1117
Mailing Address
MARYSA P WALLACE AGNP-C
1835 SAVOY DR STE 203
ATLANTA, GA 30341-1073
Phone number: 770-496-9430
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