MR. Terrell Richard Wallace, PA C is a medical physician assistant in Warner Robins, GA. MR. Terrell Richard Wallace, PA C NPI is 1356399828. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
136 SOUTH HOUSTON LAKE ROAD
WARNER ROBINS, GA
ZIP 31088
Phone: (478) 953-1020
Fax: (478) 953-5406
The enumeration date for this NPI number is 5/5/2006 and was last updated on 9/18/2012.