Eric Wallace
Eric Wallace is a Student in an Organized Health Care Education/Training Program in Shreveport, Louisiana. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
1501 Kings HwyShreveport, LA 71103-4228
Phone: (318) 675-6483
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1780372904 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 26, 2023 |
| Last updated in NPPES | June 13, 2023 |
| Certification date | June 13, 2023 |
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