MR. Robert Eric Wallace, APN

NPI #1720007156 in Macomb, Illinois

Provider Information

NPI Number
1720007156
Entity Type
Individual
Name
MR. Robert Eric Wallace, APN
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Nurse Practitioner - Family
Credential
APN
Enumeration Date
Jul 18, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
1 UNIVERSITY CIR
City
Macomb
ZIP Code
61455-1367
Phone
(309) 298-1888

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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