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1851614739
CARRIE ESTHER WALLACE
GRAND FORKS, ND
NPI
1851614739
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Former Name
CARRIE ESTHER IVERSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ND 995)
Enumeration Date
2010-03-08
Last Update Date
2010-03-08
Business Address
CARRIE ESTHER WALLACE PA
1000 S COLUMBIA RD
GRAND FORKS, ND 58201-4032
Phone number: 701-780-5000
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Mailing Address
CARRIE ESTHER WALLACE PA
1000 S COLUMBIA RD PO BOX 6002
GRAND FORKS, ND 58201-4032
Phone number: 701-780-5000
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