JEFFREY MICHAEL WALLACE

FORT RILEY, KS
NPI1619392974
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2014-02-24
Last Update Date2014-02-24
Business Address
JEFFREY MICHAEL WALLACE
600 CAISSON HILL RD
FORT RILEY, KS 66442-7037
Phone number: 785-239-7000
Mailing Address
JEFFREY MICHAEL WALLACE
600 CAISSON HILL RD
FORT RILEY, KS 66442-7037
Phone number: 785-239-7000
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