Search › Pennsylvania › 101YM0800X
Kelly Wallace
NPI 1427726793 · on the registry since 2021 · sole proprietor
Practice
- Address
- 1348 Bainbridge St
Philadelphia, PA 19147 - Phone
- (215) 563-0652
- Organisation at this address
- Mazzoni Center
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 30
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Sex
- Male
- Record last updated
- 2021-09-01
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 Pennsylvania