Wallace Henry JR.

NPI #1316311715 in Mesa, Arizona

Provider Information

NPI Number: 1316311715
Entity Type: Individual
Name: Wallace Henry JR.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist/Technologist, Other - Surgical Technologist
Enumeration Date: Nov 23, 2015
Last Updated: Nov 23, 2015

Practice Location

Address: 1055 S STAPLEY DR
City: Mesa
State: Arizona
ZIP Code: 85204
Phone: (480) 833-9100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist, Other - Surgical Technologist — Surgical Technologist	246ZS0410X	Primary

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