DANIEL LELAND WALLACE

GRAND RAPIDS, MI
NPI1275525875
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MI  5101011648)
Enumeration Date2005-08-19
Last Update Date2021-02-19
Business Address
Dr. DANIEL LELAND WALLACE DO
25 MICHIGAN ST NE SUITE 5100
GRAND RAPIDS, MI 49503-2515
Phone number: 616-267-0800
Mailing Address
Dr. DANIEL LELAND WALLACE DO
100 MICHIGAN ST NE # MC-845
GRAND RAPIDS, MI 49503-2560
Phone number: 616-267-0800
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