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1114114832
MARY CHRISTENA WALLACE
FARMINGTON, UT
NPI
1114114832
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: UT 206301-3102)
Enumeration Date
2007-09-26
Last Update Date
2007-09-26
Business Address
MARY CHRISTENA WALLACE RN
50 E STATE ST
FARMINGTON, UT 84025-2343
Phone number: 801-451-3315
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Mailing Address
MARY CHRISTENA WALLACE RN
PO BOX 618
FARMINGTON, UT 84025-0618
Phone number:
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