Lowell Wallace's National Provider Identifier (NPI) Details
Lowell Wallace,
NPI: 1932610623
Enumeration Date: 2017-10-20
Last updated: 2018-03-17
Sole Proprietor: NO
Status: active
Postal Address: 1120 E MAIN ST STE 24, PHILADELPHIA, MS
Phone: 601-781-8677
Primary Practice Address: 1120 E MAIN ST STE 24, PHILADELPHIA, MS
Practice's phone: 601-781-8677