BRENT E WALLACE

ROY, UT
NPI1124136221
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: UT  771610101205)
Enumeration Date2006-08-28
Last Update Date2008-07-10
Business Address
Dr. BRENT E WALLACE MD
1915 W 5950 S
ROY, UT 84067-1454
Phone number: 801-387-8100
Mailing Address
Dr. BRENT E WALLACE MD
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-387-8100
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