John R. Wallis D.MIN.

NPI 1023161197 - Counselor - 101YP1600X

NPI Details
NPI 1023161197
Gender Male
Enumeration Date 01/19/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1417 SE 4TH ST
FT LAUDERDALE FL, 33301-2319, US
Phone (954) 463-2273
Fax (954) 779-1643
Business Location
1417 SE 4TH ST
FT LAUDERDALE FL, 33301-2319, US
Phone (954) 463-2273
Fax (954) 779-1643
Toxanomy
Taxonomy Code 101YP1600X
License State Florida
License Number MT1251
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According to our database, Dr. John R. Wallis D.MIN. NPI is 1023161197, taxonomy code is 101YP1600X and license number is MT1251, license state is located at Florida. John R. Wallis D.MIN. physically located at 1417 Se 4th St, Ft Lauderdale FL, 33301-2319. NPI Number John R. Wallis D.MIN. has the Individual type.

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1023161197 NPI number is provided on an as is basis without warranty of any kind. 1023161197 is maintained by the National Plan & Provider Enumeration System. The contents of John R. Wallis D.MIN. are for informational purposes only.