Search › New Jersey › 101YP1600X
Coleman Wallace
NPI 1720863913 · on the registry since 2023
Practice
- Address
- 15 Edge Ct
Willingboro, NJ 08046 - Phone
- (609) 500-7139
Registry record
- Primary taxonomy
- 101YP1600X
101YP1600X
- Licence states on file
- NJ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-08-30
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 New Jersey