Ray L Wallace JR., PA

NPI #1720014624 in Savannah, Georgia

Provider Information

NPI Number: 1720014624
Entity Type: Individual
Name: Ray L Wallace JR., PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 23, 2006
Last Updated: Feb 23, 2021

Practice Location

Address: 4425 PAULSEN ST
City: Savannah
State: Georgia
ZIP Code: 31405-3662
Phone: (912) 355-6615

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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