BRIAN KEN WALLACE

MILWAUKEE, WI
NPI1659488690
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: WI  27108)
Enumeration Date2006-08-24
Last Update Date2023-09-22
Business Address
Dr. BRIAN KEN WALLACE MD
2801 W KINNICKINNIC RIVER PKWY #250
MILWAUKEE, WI 53215
Phone number: 414-649-6732
Mailing Address
Dr. BRIAN KEN WALLACE MD
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 414-649-6732