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1538740774
JOHN WALLACE
MODESTO, CA
NPI
1538740774
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-04-19
Last Update Date
2023-10-23
Business Address
JOHN WALLACE
1620 CUMMINS DR
MODESTO, CA 95358-6400
Phone number: 209-969-0363
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Mailing Address
JOHN WALLACE
1620 CUMMINS DR
MODESTO, CA 95358-6400
Phone number: 209-969-0363
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