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1477707685
J. MICHAEL WALLACE
SALT LAKE CITY, UT
NPI
1477707685
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: UT 7471598-1205)
Enumeration Date
2008-11-14
Last Update Date
2012-06-14
Business Address
DR. J. MICHAEL WALLACE M.D.
1528 LAIRD AVE
SALT LAKE CITY, UT 84105-1730
Phone number: 503-475-8549
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Mailing Address
DR. J. MICHAEL WALLACE M.D.
821 S 600 E
SALT LAKE CITY, UT 84102-3507
Phone number: 503-475-8549
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