Organization
VETERANS HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STACEY WALLACE (CHIEF, PROSTHETICS)
(561) 422-5559
Entity
Organization
Contact information
Practice address
7305 N MILITARY TRL, RIVIERA BEACH, FL 33410-7417
(561) 422-8232
Mailing address
7305 N MILITARY TRL, RIVIERA BEACH, FL 33410-7417
(561) 422-8232
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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