JACOB WALLACE

SAINT LOUIS, MO
NPI1124604061
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-03-22
Last Update Date2021-03-22
Business Address
Dr. JACOB WALLACE MD
6420 CLAYTON RD
SAINT LOUIS, MO 63117-1811
Phone number: 314-768-8000
Mailing Address
Dr. JACOB WALLACE MD
904 LAMBETH CIR APT 208
DURHAM, NC 27705-4587
Phone number: 989-751-6079
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