MR. Steven Gregory Wallace JR., PA

NPI #1851713952 in Plant City, Florida

Provider Information

NPI Number: 1851713952
Entity Type: Individual
Name: MR. Steven Gregory Wallace JR., PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jan 9, 2014
Last Updated: Jan 9, 2014

Practice Location

Address: 511 W ALEXANDER ST
City: Plant City
State: Florida
ZIP Code: 33563-7116
Phone: (813) 659-9800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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