Individual
WARREN LEE WALLACE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 CHRISTINE AVE, ANNISTON, AL 36207-3263
(256) 237-0752
(256) 236-9572
Mailing address
1900 CHRISTINE AVE, ANNISTON, AL 36207-3263
(256) 237-0752
(256) 236-9572
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A7476
AL
Other
Enumeration date
10/01/2005
Last updated
07/08/2007
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