Terrell Wallace, PA C

NPI 1356399828 · on the registry since 2006

Practice

Address: 136 South Houston Lake Road
Warner Robins, GA 31088
Phone: (478) 953-1020
Fax: (478) 953-5406
Organisation at this address: William E Freeman, Md
William E. Freeman, Md
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-09-18

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