Individual
ALEXANDRA BALTAZAR WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
507 KIMBERTON RD, PHOENIXVILLE, PA 19460-4745
(610) 243-9117
Mailing address
507 KIMBERTON RD, PHOENIXVILLE, PA 19460-4745
(610) 243-9117
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
05/31/2025
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