Individual
MRS. MARILYN G WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2707 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9458
(919) 735-9146
(919) 735-0582
Mailing address
2707 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9458
(919) 735-9146
(919) 735-0582
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
33514
NC
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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