BRANDON WALLACE

SOUTHFIELD, MI
NPI1700395274
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: MI  5501018432)
Enumeration Date2017-09-27
Last Update Date2017-09-27
Business Address
BRANDON WALLACE PT
29900 SOUTHFIELD RD
SOUTHFIELD, MI 48076-2090
Phone number: 248-663-0400
Mailing Address
BRANDON WALLACE PT
790 REMINGTON BLVD
BOLINGBROOK, IL 60440-4909
Phone number:
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