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1174261820
BRANDON WALLACE
FARMINGTON HILLS, MI
NPI
1174261820
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: MI 5151015898)
Enumeration Date
2022-05-23
Last Update Date
2022-05-24
Business Address
BRANDON WALLACE
28050 GRAND RIVER AVE
FARMINGTON HILLS, MI 48336-5919
Phone number: 947-521-7265
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Mailing Address
BRANDON WALLACE
28050 GRAND RIVER AVE
FARMINGTON HILLS, MI 48336-5919
Phone number:
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