KEVIN L WALLACE

PHOENIX, AZ
NPI1730128372
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2083T0002X Preventive Medicine, Medical Toxicology
(Licence: AZ  23348)
Enumeration Date2006-06-06
Last Update Date2007-07-08
Business Address
-- KEVIN L WALLACE MD
925 E MCDOWELL RD
PHOENIX, AZ 85006-2502
Phone number: 602-239-2371
Mailing Address
-- KEVIN L WALLACE MD
72 BRENTWOOD RD
CAPE ELIZABETH, ME 04107-2227
Phone number: 602-769-1301
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