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1245005149
CONNOR WALLACE
SALT LAKE CITY, UT
NPI
1245005149
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
Enumeration Date
2023-11-20
Last Update Date
2024-03-04
Business Address
CONNOR WALLACE
85 N MEDICAL DR
SALT LAKE CITY, UT 84112-1100
Phone number: 801-587-3422
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Mailing Address
CONNOR WALLACE
445 N HALE ST
GRANTSVILLE, UT 84029-9398
Phone number:
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