Individual
LEIGH A WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 COUNTY ROAD 360, FLORENCE, AL 35634-5252
(256) 335-5773
Mailing address
170 COUNTY ROAD 360, FLORENCE, AL 35634-5252
(256) 335-5773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-100834
AL
363LF0000X
Family Nurse Practitioner
Primary
1-100834
AL
Other
Enumeration date
01/21/2021
Last updated
09/15/2023
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