Darcie L Wallace PA-C

NPI 1083648489 - Physician Assistant - 363AS0400X

NPI Details
NPI 1083648489
Gender Female
Enumeration Date 07/10/2006
Last Updated 10/22/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
SAINT LOUIS MO, 63141-8221, US
Phone (314) 251-6000
Business Location
PO BOX 180575
SAINT LOUIS MO, 63150-3511, US
Phone (314) 251-6000
Taxonomy Code 363AS0400X
License State Missouri
License Number 118539
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According to our database, Darcie L Wallace PA-C NPI is 1083648489, taxonomy code is 363AS0400X and license number is 118539, license state is located at Missouri. Darcie L Wallace PA-C physically located at 615 S New Ballas Rd, Saint Louis MO, 63141-8221. NPI Number Darcie L Wallace PA-C has the Individual type.

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1083648489 NPI number is provided on an as is basis without warranty of any kind. 1083648489 is maintained by the National Plan & Provider Enumeration System. The contents of Darcie L Wallace PA-C are for informational purposes only.