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1154356467
JOHN MARK WALLACE
SALT LAKE CITY, UT
NPI
1154356467
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Other Name
J. MARK WALLACE
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: UT 3169351701)
Enumeration Date
2006-07-12
Last Update Date
2007-07-08
Business Address
Mr. JOHN MARK WALLACE R.Ph.
500 FOOTHILL BLVD
SALT LAKE CITY, UT 84148-0001
Phone number: 801-582-1565
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Mailing Address
Mr. JOHN MARK WALLACE R.Ph.
1422 E 9090 S
SANDY, UT 84093-2203
Phone number: 801-582-1565
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