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1255713301
NOAH ISADORE WALLACE
FALLS CHURCH, VA
NPI
1255713301
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: VA 0102205033)
Enumeration Date
2015-06-25
Last Update Date
2019-01-04
Business Address
Dr. NOAH ISADORE WALLACE D.O.
502 W BROAD ST STE 2
FALLS CHURCH, VA 22046-3206
Phone number: 571-421-8431
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Mailing Address
Dr. NOAH ISADORE WALLACE D.O.
ANDREWS MALCOLM GROW FAMILY HEALTH CLINIC 11TH MEDICAL OPERATIONS SQUADRON
APO, AA 20762
Phone number:
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