Individual
MORGAN DAWN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 E PRIMROSE ST STE 270, SPRINGFIELD, MO 65807-5177
(417) 882-6900
Mailing address
1000 E PRIMROSE ST STE 270, SPRINGFIELD, MO 65807-5177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2025004005
MO
Other
Enumeration date
02/13/2025
Last updated
03/11/2025
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