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1952182719
JESSIE WALLACE
PRESTONSBURG, KY
NPI
1952182719
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-10-09
Last Update Date
2023-10-09
Business Address
JESSIE WALLACE
104 S FRONT AVE
PRESTONSBURG, KY 41653-1614
Phone number: 606-886-8572
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Mailing Address
JESSIE WALLACE
104 S FRONT AVE
PRESTONSBURG, KY 41653-1614
Phone number: 606-886-8572
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