Individual provider · Type 1 NPI

Ima Latoya Wallace

Other Technician · Jacksonville, FL

NPI number 1053063834 Active

Practice location

9951 Atlantic Blvd Ste 300
Jacksonville, FL 32225-6574

Call (833) 434-5223 Map

Fax (888) 686-6271

Specialties and licenses

TaxonomyCodeLicense
Other Technician Primary 247200000XNone listed

Other Technician: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

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About NPI 1053063834

Ima Latoya Wallace's National Provider Identifier is 1053063834, issued on Jan 22, 2022. The primary taxonomy on file is Other Technician (247200000X), and the practice location is in Jacksonville, FL. The record was last updated on Jun 17, 2022.