Search › Georgia › 171W00000X
Jahqwale Wallace
NPI 1053822999 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1501 Myrtle St Apt C3
Valdosta, GA 31601 - Phone
- (912) 704-9805
Registry record
- Primary taxonomy
- 171W00000X
171W00000X
- Sex
- Female
- Record last updated
- 2017-10-18
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