SHELBY L. WALLACE

PEORIA, IL
NPI1982267696
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IL  209-019301)
Enumeration Date2019-04-18
Last Update Date2019-04-18
Business Address
SHELBY L. WALLACE CRNA
8600 STATE ROUTE 91 STE 250
PEORIA, IL 61615-7831
Phone number: 309-692-5393
Mailing Address
SHELBY L. WALLACE CRNA
8600 STATE ROUTE 91 STE 250
PEORIA, IL 61615-7831
Phone number: 309-692-5393
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