MISS Jennifer Marie Wallace, L.A.C
NPI #1124579602 in Redondo Beach, California
Provider Information
- NPI Number
- 1124579602
- Entity Type
- Individual
- Name
- MISS Jennifer Marie Wallace, L.A.C
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Acupuncturist
- Credential
- L.A.C
- Enumeration Date
- Oct 19, 2016
- Last Updated
- Dec 22, 2016
Practice Location
- Address
- 237 AVENIDA DEL NORTE
- City
- Redondo Beach
- State
- California
- ZIP Code
- 90277-5702
- Phone
- (310) 483-4957
Specialties & Taxonomy Codes
| Specialty |
|---|
| Acupuncturist |
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