JOHN WALLACE SR., IDC

Military Health Care Provider - Independent Duty Corpsman

Active Individual
NPI: 1316926066

Practice Address

300 E MAIN ST
SUITE 1000
Norfolk, VA 23510

Phone: (757) 628-4347

Specialties

Specialty Code Primary License
Military Health Care Provider - Independent Duty Corpsman 1710I1002X Yes -

Frequently Asked Questions

NPI 1316926066 is the National Provider Identifier for JOHN WALLACE SR., IDC, a Military Health Care Provider - Independent Duty Corpsman provider located in Norfolk, VA. This NPI was enumerated on January 11, 2006.
JOHN WALLACE SR., IDC practices at 300 E MAIN ST, SUITE 1000, Norfolk, VA 23510.

Quick Facts

NPI
1316926066
Type
Individual
Enumerated
Jan 11, 2006
Last Updated
Jul 8, 2007

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