Individual
MS. ARYN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
290 I O O F AVE, GILROY, CA 95020-5204
(408) 846-2100
Mailing address
374 VALE DR, SAN JOSE, CA 95123-4427
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 25875
CA
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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