James Joseph Wallace, ATC

NPI #1992023212 in Hartwell, Georgia

Provider Information

NPI Number: 1992023212
Entity Type: Individual
Name: James Joseph Wallace, ATC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: ATC
Enumeration Date: May 11, 2010
Last Updated: May 11, 2010

Practice Location

Address: 154 SUGAR CANE DR
City: Hartwell
State: Georgia
ZIP Code: 30643-8120
Phone: (678) 316-3604

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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