Individual
MR. SPENCER RILEY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
713 GOODYEAR AVE, GADSDEN, AL 35903-1156
(256) 492-4040
Mailing address
PO BOX 697, BOAZ, AL 35957-0697
(256) 840-8181
(256) 744-7272
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-147129
AL
Other
Enumeration date
06/01/2020
Last updated
09/13/2023
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