person
Mr. Kevin Wallace
Student in an Organized Health Care Education/Training Program in Boston, Massachusetts
NPI 1225388457

Kevin Wallace is a Student in an Organized Health Care Education/Training Program based in Brighton, MA. Kevin Wallace practices in Boston, MA. The NPI Number for Kevin Wallace is 1225388457 and holds a License No. S50607188 (Massachusetts).

The current practice location address for Kevin Wallace is 30 Warren St, Boston, MA and can be reached out via phone at 617-254-3800.

Location: 30 Warren St, Boston, MA, 02135-2591
person
Provider Profile Details
NPI Number
1225388457
Provider Name
Kevin Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
30 Warren St, Boston, MA, 02135-2591
Phone Number
617-254-3800
Fax Number
Provider Enumeration Date
09/14/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
30 Warren St
City
State
Zip
02135-3602
Phone Number
617-254-3800
Fax Number
person
Provider Business Mailing Address Details
Address
30 Warren St
City
State
Zip
02135-3602
Phone Number
617-254-3800
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
S50607188 (Massachusetts)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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