Individual
MS. LEE S. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN, FADA
Contact information
Practice address
711 JEFFERSON AVE, MEMPHIS, TN 38105-5003
(901) 448-6511
(901) 448-7097
Mailing address
711 JEFFERSON AVE, MEMPHIS, TN 38105-5003
(901) 448-6511
(901) 448-7097
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
LDN0000000356
TN
Other
Enumeration date
07/14/2006
Last updated
06/24/2008
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