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1518939867
KELLI P WALLACE
FORT DODGE, IA
NPI
1518939867
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IA 33478)
Enumeration Date
2006-02-02
Last Update Date
2016-12-22
Business Address
-- KELLI P WALLACE MD
800 KENYON RD
FORT DODGE, IA 50501-5776
Phone number: 515-574-6800
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Mailing Address
-- KELLI P WALLACE MD
24 N 9TH ST SUITE A
FORT DODGE, IA 50501-3909
Phone number: 515-574-6890
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