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1992408587
AMANDA WALLACE
PENSACOLA, FL
NPI
1992408587
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: FL APRN11024430)
Enumeration Date
2023-03-23
Last Update Date
2023-07-19
Business Address
AMANDA WALLACE APRN
1657 TRINITY DR # A
PENSACOLA, FL 32504-5708
Phone number: 850-415-2400
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Mailing Address
AMANDA WALLACE APRN
4205 BELFORT RD STE 4015
JACKSONVILLE, FL 32216-3623
Phone number: 904-450-6063
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