Individual
DR. ELAINE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3200 S UNIVERSITY DR, #4316, DAVIE, FL 33328-2018
(954) 262-4316
Mailing address
3001 W ROLLING HILLS CIR, 1-408, DAVIE, FL 33328-1948
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
OS8356
FL
Other
Enumeration date
05/22/2006
Last updated
09/25/2013
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