Theresa Wallace, OWNER

Practice location

Address

1200 Ac Evans St APT 2, Riviera Beach, FL 33404-2063

Phone

(561) 634-6091

Fax

(561) 828-2343

Registered specialties

Registry record

NPI

1013498039

Entity type

Individual

Sex (as registered)

Female

NPI issued

27 Aug 2018

Record last updated

27 Aug 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.