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1487912382
JOHN M WALLACE
HOUSTON, TX
NPI
1487912382
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
222Z00000X Orthotist
(Licence: TX 171)
Enumeration Date
2012-04-27
Last Update Date
2012-04-27
Business Address
-- JOHN M WALLACE LO
11155 MAIN ST
HOUSTON, TX 77025-5600
Phone number: 713-474-4171
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Mailing Address
-- JOHN M WALLACE LO
11155 MAIN ST
HOUSTON, TX 77025-5600
Phone number: 713-474-4171
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