DR. Richard M. Wallace, M.D.

NPI #1881656940 in Bozeman, Montana

Provider Information

NPI Number
1881656940
Entity Type
Individual
Name
DR. Richard M. Wallace, M.D.
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Specialist
Credential
M.D.
Enumeration Date
Apr 4, 2006
Last Updated
Jul 9, 2007

Practice Location

Address
925 HIGHLAND BLVD.,
Address 2
SUITE 1180
State
Montana
ZIP Code
59715
Phone
(406) 587-8631

Specialties & Taxonomy Codes

Specialty
Specialist

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