Individual
MS. ALLISON MARIE WALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3345 WATERMAN WAY, TAVARES, FL 32778-5220
(352) 742-2050
(352) 343-0154
Mailing address
3345 WATERMAN WAY, TAVARES, FL 32778-5220
(352) 742-2050
(352) 343-0154
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106452
FL
Other
Enumeration date
04/12/2012
Last updated
11/07/2018
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