MR. Paul David Wallace

NPI #1114044799 in Stockton, California

Provider Information

NPI Number
1114044799
Entity Type
Individual
Name
MR. Paul David Wallace
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Licensed Psychiatric Technician
Enumeration Date
Mar 26, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
1212 N CALIFORNIA ST
ZIP Code
95202-1552
Phone
(209) 468-3760

Specialties & Taxonomy Codes

Specialty
Licensed Psychiatric Technician

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