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1992915532
GREGORY WALLACE
JONESBORO, AR
NPI
1992915532
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-05-23
Last Update Date
2007-07-08
Business Address
-- GREGORY WALLACE
2707 BROWNS LN
JONESBORO, AR 72401-7213
Phone number: 870-972-4939
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Mailing Address
-- GREGORY WALLACE
2707 BROWNS LN
JONESBORO, AR 72401-7213
Phone number: 870-972-4939
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