Individual
WALLACE ANGUS TIMMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1155 MARSHELL RD, WETUMPKA, AL 36093-3527
(334) 322-0851
Mailing address
1155 MARSHELL RD, WETUMPKA, AL 36093-3527
(334) 322-0851
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12687
AL
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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