Individual
JALDON WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 W GERMANTOWN PIKE STE 400, PLYMOUTH MEETING, PA 19462-1046
(215) 316-1776
Mailing address
600 W GERMANTOWN PIKE STE 400, PLYMOUTH MEETING, PA 19462-1046
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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