Latoya M. Wallace, PA

NPI #1073764114 in Pensacola, Florida

Provider Information

NPI Number
1073764114
Entity Type
Individual
Name
Latoya M. Wallace, PA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
PA
Enumeration Date
Oct 7, 2008
Last Updated
Apr 15, 2020

Practice Location

Address
1010 N 12TH AVE STE 125
State
Florida
ZIP Code
32501-3315
Phone
(850) 361-8598

Specialties & Taxonomy Codes

Specialty
Physician Assistant - SurgicalSurgical
Physician Assistant - MedicalMedical
Physician Assistant

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