Individual
MRS. JAMIE RENEE' WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
201 - HOSPITAL DRIVE, DOVER, OH 44622
(330) 343-6631
(330) 343-8188
Mailing address
201 - HOSPITAL DRIVE, DOVER, OH 44622
(330) 343-6631
(330) 343-8188
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.287814
OH
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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