BRYAN MICHAEL WALLACE

CAMP LEJEUNE, NC
NPI1336825926
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date2023-06-27
Last Update Date2023-06-30
Business Address
BRYAN MICHAEL WALLACE SOIDC
1ST MARINE RAIDER BATTALION STONE BAY
CAMP LEJEUNE, NC 28542
Phone number: 910-440-2504
Mailing Address
BRYAN MICHAEL WALLACE SOIDC
PSC BOX 20184
CAMP LEJEUNE, NC 28542
Phone number: 910-440-2504
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