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1679550875
WELDON WALLACE
GRAND RAPIDS, MI
NPI
1679550875
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MI 4301085136)
Enumeration Date
2005-12-28
Last Update Date
2007-07-08
Business Address
-- WELDON WALLACE MD
1260 EKHART ST NE
GRAND RAPIDS, MI 49503-1372
Phone number: 616-356-5202
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Mailing Address
-- WELDON WALLACE MD
1260 EKHART ST NE 112
GRAND RAPIDS, MI 49503-1372
Phone number: 616-356-5202
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