SAM A WALLACE

MISSOULA, MT
NPI1144353707
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: MT  8667)
Enumeration Date2007-03-13
Last Update Date2007-07-08
Business Address
Dr. SAM A WALLACE D.O.
341 W PINE ST
MISSOULA, MT 59802-4119
Phone number: 406-327-0269
Mailing Address
Dr. SAM A WALLACE D.O.
341 W PINE ST
MISSOULA, MT 59802-4119
Phone number: 406-327-0269
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