MS. Micah R Wallace, PA-C
NPI #1588946214 in Latrobe, Pennsylvania
Provider Information
- NPI Number
- 1588946214
- Entity Type
- Individual
- Name
- MS. Micah R Wallace, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Surgical
- Credential
- PA-C
- Enumeration Date
- Sep 20, 2011
- Last Updated
- Dec 21, 2018
Practice Location
- Address
- 100 EXCELA HEALTH DR STE 102
- City
- Latrobe
- State
- Pennsylvania
- ZIP Code
- 15650-9001
- Phone
- (724) 804-1760
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Surgical — Surgical |
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