Gregory Roy Wallace, MSW
NPI #1073902250 in Van Nuys, California
Provider Information
- NPI Number
- 1073902250
- Entity Type
- Individual
- Name
- Gregory Roy Wallace, MSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Rehabilitation Practitioner
- Credential
- MSW
- Enumeration Date
- Jan 12, 2015
- Last Updated
- Jan 12, 2015
Practice Location
- Address
- 14545 SHERMAN CIR
- City
- Van Nuys
- State
- California
- ZIP Code
- 91405-3087
- Phone
- (818) 374-6901
Specialties & Taxonomy Codes
| Specialty |
|---|
| Rehabilitation Practitioner |
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