DONALD R. WALLACE

PEORIA, IL
NPI1700899788
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036-077680)
Enumeration Date2006-08-14
Last Update Date2010-07-29
Business Address
-- DONALD R. WALLACE M.D.
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-683-6600
Mailing Address
-- DONALD R. WALLACE M.D.
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-683-6600
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