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JAHQWALE WALLACE

Contractor

NPI: 1053822999Individual

Specialties, Licenses & Credentials

ContractorPrimary

Contractor

Code: 171W00000X

Contact & Hours

Address
1501 MYRTLE ST APT C3
VALDOSTA, GA 31601

Quick Facts

NPI
1053822999
Entity Type
Individual
Gender
Female
Medicare
Not confirmed
Specialties
1
Locations
1

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