Individual
MS. PATRICIA M WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P.
Contact information
Practice address
217 1ST ST, NEPTUNE BEACH, FL 32266-6145
(904) 962-4742
Mailing address
1015 ATLANTIC BLVD, SUITE 123, ATLANTIC BEACH, FL 32233-3313
(904) 962-4742
(904) 962-4742
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP1523
FL
Other
Enumeration date
09/03/2008
Last updated
03/01/2009
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