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Khalil Wallace
NPI 1528516580 · on the registry since 2016 · sole proprietor
Practice
- Address
- 7275 Nebraska Ave
Fairchild Afb, WA 99011 - Phone
- (786) 512-1492
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 2255A2300X
- Sex
- Male
- Record last updated
- 2016-09-19
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 Washington