Mr. Kevin Wallace
Mr. Kevin Wallace is a Student in an Organized Health Care Education/Training Program in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2012.
- Licensed in
- MA
- In the registry since
- 2012
Practice location Address checks out
30 Warren StBoston, MA 02135-3602
Phone: (617) 254-3800
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X · Licence S50607188 (MA) |
|---|
Record details
| NPI number | 1225388457 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 14, 2012 |
| Last updated in NPPES | September 14, 2012 |
| Mailing address | 555 Washington St, Brighton, MA 02135-2591 |
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