Individual
STEVEN EARL WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
1065 BUCKS LAKE RD, QUINCY, CA 95971-9507
(530) 283-7155
(530) 283-1838
Mailing address
2704 RIDGERUN RD, QUINCY, CA 95971-9380
(530) 283-3504
(530) 283-1838
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
243U00000X
—
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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