Individual
MS. MEGAN E. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-1779
Mailing address
3141 SOMERSET DR, SHAKER HEIGHTS, OH 44122-3812
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005014RX
OH
Other
Enumeration date
02/13/2017
Last updated
05/03/2017
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