Terrell Richard Wallace PA C

NPI # 

Practice Address:

136 South Houston Lake Road

Warner Robins, GA, 31088

Practice Phone:

478-953-1020

Practice Fax:

478-953-5406

License Number:

002665

License State:

GA

Taxonomy Grouping:

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy Classification:

Physician Assistant

Taxonomy Specialization:

Medical

Taxonomy Code:

363AM0700X