BRUCE ALLEN WALLACE

FLINT, MI
NPI1881124816
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: MI  5101025046)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: IL  036171615)
207P00000X Emergency Medicine
(Licence: IN  02006388A)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-06-13
Last Update Date2024-08-30
Business Address
Dr. BRUCE ALLEN WALLACE DO
401 S BALLENGER HWY
FLINT, MI 48532-3638
Phone number: 810-342-2000
Mailing Address
Dr. BRUCE ALLEN WALLACE DO
22200 GREEN HILL RD APT 99
FARMINGTON HILLS, MI 48335-4360
Phone number: 314-401-4941