Individual
MR. WALLACE D CLEVELAND JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-7300
Mailing address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/10/2017
Last updated
08/03/2023
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