Individual
MRS. MOLLY SUE WALLACE-WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1 FREDERICK ST, WAVERLY, NY 14892-1207
(607) 565-2841
(607) 565-4997
Mailing address
1 FREDERICK ST, WAVERLY, NY 14892-1207
(607) 565-2841
(607) 565-4997
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
489985
NY
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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