MS. Stacey Marie Wallace
NPI #1700149838 in Fredonia, New York
Provider Information
- NPI Number
- 1700149838
- Entity Type
- Individual
- Name
- MS. Stacey Marie Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Enumeration Date
- Jun 22, 2012
- Last Updated
- Jun 22, 2012
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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