NPI 1083463947

Angel Sha'Miah Wallace, CPCTA

Practitioner Other Technician Birmingham, AL

Practice location

Address: 2609 Avenue K, Birmingham, AL 35218-2159
Phone: (659) 910-1100

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence PF4Q3Z3H9 (AL)

Other Technician, Other providers in Alabama →

Registry record

NPI: 1083463947
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 May 2024
Record last updated: 14 May 2024

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.