Glenn Wallace
NPI #1013410778 in Boulder City, Nevada
Provider Information
- NPI Number
- 1013410778
- Entity Type
- Individual
- Name
- Glenn Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Rehabilitation Practitioner
- Enumeration Date
- Mar 8, 2018
- Last Updated
- Mar 8, 2018
Practice Location
- Address
- 200 WILSON CIR
- City
- Boulder City
- State
- Nevada
- ZIP Code
- 89005-4401
- Phone
- (702) 294-7100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Rehabilitation Practitioner |
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