Individual
MR. WALLACE BARRETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1215 FRANCISCAN DR, LITCHFIELD, IL 62056-1778
(217) 324-8389
Mailing address
PO BOX 10484, BIRMINGHAM, AL 35202-0484
(800) 339-5844
(866) 759-5426
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041.406110
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209012598
IL
Other
Enumeration date
02/02/2015
Last updated
11/17/2022
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