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Trevor Wallace

NPI 1003339094 · on the registry since 2017 · sole proprietor

Practice

Address
571 Eva Kennedy Rd Apt 8
Suwanee, GA 30024
Phone
(770) 369-1497

Registry record

Primary taxonomy
Contractor
171W00000X
Sex
Male
Record last updated
2022-07-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia