Individual
MR. JOSEPH ANTHONY WALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN MPH
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
Mailing address
PO BOX 507, MORRO BAY, CA 93443-0507
(805) 772-5181
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 82442
CA
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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