Individual
MRS. ASHLEY B WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1402 9TH AVE, ALTOONA, PA 16602-2415
(814) 940-2000
(814) 569-1878
Mailing address
1402 9TH AVE, ALTOONA, PA 16602-2415
(814) 940-2000
(814) 569-1878
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053915
PA
Other
Enumeration date
08/04/2009
Last updated
08/04/2009
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