Brandon Wallace

NPI #1174261820 in Farmington Hills, Michigan

Provider Information

NPI Number: 1174261820
Entity Type: Individual
Name: Brandon Wallace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthopaedic Surgery
Enumeration Date: May 23, 2022
Last Updated: May 24, 2022

Practice Location

Address: 28050 GRAND RIVER AVE
City: Farmington Hills
State: Michigan
ZIP Code: 48336-5919
Phone: (947) 521-7265

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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