Individual
ROBERT E WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
283 OLD COLLIERS WAY, WEIRTON, WV 26062-4073
(304) 780-6210
Mailing address
283 OLD COLLIERS WAY, WEIRTON, WV 26062-4073
(304) 780-6210
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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