ROBERT JASON WALLACE

DETROIT, MI
NPI1972325603
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI  2601001545)
Enumeration Date2024-10-24
Last Update Date2024-10-24
Business Address
Mr. ROBERT JASON WALLACE ATC
261 MACK AVE
DETROIT, MI 48201-2417
Phone number: 313-966-7246
Mailing Address
Mr. ROBERT JASON WALLACE ATC
8946 SAN MARCO BLVD
STERLING HEIGHTS, MI 48313-4866
Phone number: 586-488-6467
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