MICHAEL ALAN WALLACE

ALBUQUERQUE, NM
NPI1003057852
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NM  R48828)
Enumeration Date2009-03-07
Last Update Date2013-03-11
Business Address
Mr. MICHAEL ALAN WALLACE CNP
8210 LOUISIANA BLVD NE SUITE C
ALBUQUERQUE, NM 87113-1761
Phone number: 505-858-1222
Mailing Address
Mr. MICHAEL ALAN WALLACE CNP
8210 LOUISIANA BLVD NE SUITE C
ALBUQUERQUE, NM 87113-1761
Phone number: 505-858-1222
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