Individual
MISS ALEXANDRIA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HAD
Contact information
Practice address
910 N 5TH ST STE 36, CORDELE, GA 31015-3254
(229) 273-4855
Mailing address
910 N 5TH ST STE 36, CORDELE, GA 31015-3254
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HADS001048
GA
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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