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Dr. Julie A Wallace

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NPI Number Detailed Information

Provider Information:

Name: Dr. Julie A Wallace
Gender: F
Provider License Number If Given: 35073269

NPI Information:

NPI: 1871592329
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 7/20/2020

Provider Business Mailing Address:

Address: 3515 MASSILLON RD STE 300
Uniontown, OH 44685
Phone Number: 3308999350
Fax Number: 3306341329

Provider Business Practice Location Address:

Address: 4444 ARLINGTON RD
Uniontown, OH 44685
Phone Number: 3308966111
Fax Number: 3306341329

Provider Taxonomy:

Primary: 207Q00000X
Secondary (if any):
State: OH

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