Individual
ANTHONY NELSON WALLACE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9001 ARBOR ST STE 206, OMAHA, NE 68124-2066
(531) 772-9325
Mailing address
2104 S 42ND ST, OMAHA, NE 68105-2910
(531) 772-9325
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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