Search › Georgia › 253Z00000X
Therrion Wallace
NPI 1316813413 · on the registry since 2025 · sole proprietor
Practice
- Address
- 2412 Antebellum Dr # A
Augusta, GA 30906 - Phone
- (706) 372-3886
Registry record
- Primary taxonomy
- 253Z00000X
253Z00000X
- Sex
- Female
- Record last updated
- 2025-10-15
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