JACOB WALLACE

SALT LAKE CITY, UT
NPI1497340475
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2021-03-02
Last Update Date2021-03-02
Business Address
JACOB WALLACE
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
Mailing Address
JACOB WALLACE
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864