Spencer Allen Wallace
NPI #1841837309 in Grand Forks Afb, North Dakota
Provider Information
- NPI Number
- 1841837309
- Entity Type
- Individual
- Name
- Spencer Allen Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pharmacist
- Enumeration Date
- Dec 4, 2019
- Last Updated
- Dec 4, 2019
Practice Location
- Address
- 1599 J ST
- City
- Grand Forks Afb
- State
- North Dakota
- ZIP Code
- 58205-6306
- Phone
- (701) 747-5382
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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