Individual
JEAN WALACE BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1436 LAWRENCE ST FL 2, RAHWAY, NJ 07065-5132
(908) 630-8928
Mailing address
1436 LAWRENCE ST FL 2, RAHWAY, NJ 07065-5132
(908) 630-8928
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/15/2025
Last updated
02/15/2025
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