WELDON WALLACE

GRAND RAPIDS, MI
NPI1679550875
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy207Q00000X Family Medicine
(Licence: MI  4301085136)
Enumeration Date2005-12-28
Last Update Date2007-07-08
Business Address
WELDON WALLACE MD
1260 EKHART ST NE
GRAND RAPIDS, MI 49503-1372
Phone number: 616-356-5202
Mailing Address
WELDON WALLACE MD
1260 EKHART ST NE 112
GRAND RAPIDS, MI 49503-1372
Phone number: 616-356-5202
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