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1922026236
CALVIN P WALLACE
COVINGTON, WA
NPI
1922026236
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WA MD00024602)
Enumeration Date
2006-07-17
Last Update Date
2010-09-10
Business Address
-- CALVIN P WALLACE MD
17700 SE 272ND ST
COVINGTON, WA 98042-4951
Phone number: 253-372-7128
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Mailing Address
-- CALVIN P WALLACE MD
PO BOX 5299
TACOMA, WA 98415-0299
Phone number: 253-372-7128
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