| NPI | 1770823213 |
|---|---|
| Doing Business As | WALLACE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JEFFREY WALLACE President 972-722-4830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-03-27 |