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Individual

DR. CYNTHIA L WALLACE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4777 ANDREW JACKSON PKWY, SUITE 101, HERMITAGE, TN 37076-1356
(615) 889-0134
(615) 889-0135
Mailing address
4777 ANDREW JACKSON PKWY, SUITE 101, HERMITAGE, TN 37076-1356
(615) 889-0134
(615) 889-0135

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD30127
TN

Other

Enumeration date
01/27/2006
Last updated
07/08/2007
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