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1013410778
GLENN WALLACE
BOULDER CITY, NV
NPI
1013410778
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2018-03-08
Last Update Date
2018-03-08
Business Address
GLENN WALLACE
200 WILSON CIR
BOULDER CITY, NV 89005-4401
Phone number: 702-294-7100
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Mailing Address
GLENN WALLACE
200 WILSON CIR
BOULDER CITY, NV 89005-4401
Phone number:
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