Individual
DR. LISA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 503-9201
Mailing address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(314) 503-9201
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2021023759
MO
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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