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1659238392
MICHAEL JON WALLACE
LAS CRUCES, NM
NPI
1659238392
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2026-01-06
Last Update Date
2026-01-06
Business Address
MICHAEL JON WALLACE CPSW
760 N MOTEL BLVD
LAS CRUCES, NM 88007-4169
Phone number: 575-527-7975
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Mailing Address
MICHAEL JON WALLACE CPSW
385 CALLE DE ALEGRA BLDG A
LAS CRUCES, NM 88005-3423
Phone number: 575-526-1105
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