Individual
SUSAN YOU WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2034 E SOUTHERN AVE STE D, TEMPE, AZ 85282-7511
(480) 923-6200
(602) 419-3101
Mailing address
2034 E SOUTHERN AVE STE D, TEMPE, AZ 85282-7511
(809) 236-2004
(602) 419-3101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7627
AZ
363AM0700X
Medical Physician Assistant
7627
AZ
Other
Enumeration date
07/03/2019
Last updated
02/10/2026
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