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1952864308
AUSTIN H WALLACE
BATON ROUGE, LA
NPI
1952864308
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA 312099)
Enumeration Date
2019-04-12
Last Update Date
2019-04-12
Business Address
AUSTIN H WALLACE PA
8080 BLUEBONNET BLVD STE 1000
BATON ROUGE, LA 70810-7827
Phone number: 225-924-2424
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Mailing Address
AUSTIN H WALLACE PA
8080 BLUEBONNET BLVD STE 1000
BATON ROUGE, LA 70810-7827
Phone number: 225-924-2424
Copy
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