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1952721672
KELLEY WALLACE JACOBS
DILLON, SC
NPI
1952721672
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Former Name
KELLEY LYNN WALLACE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner Primary Care
(Licence: SC 18972)
Enumeration Date
2014-04-21
Last Update Date
2014-07-28
Business Address
KELLEY WALLACE JACOBS DNP/FNP
705 N 8TH AVE STE 1A
DILLON, SC 29536-2549
Phone number: 843-774-2478
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Mailing Address
KELLEY WALLACE JACOBS DNP/FNP
705 N 8TH AVE STE 1A
DILLON, SC 29536-2549
Phone number: 843-774-2478
Copy
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