Individual
TINA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2408 CARSON RD UNIT 1, BIRMINGHAM, AL 35215-3102
(205) 757-0249
Mailing address
725 SUNHILL RD NW APT H, CENTER POINT, AL 35215-3043
(205) 757-0249
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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