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Individual

ALEXANDER WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
208 OLD MILL RD, MARTINSBURG, WV 25401-9219
(304) 263-5680
Mailing address
208 OLD MILL RD, MARTINSBURG, WV 25401-9219

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
107631
WV

Other

Enumeration date
03/25/2022
Last updated
03/25/2022
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