Sam Wallace, D.O

NPI 1144353707 · on the registry since 2007 · sole proprietor

Practice

Address: 341 W Pine St
Missoula, MT 59802
Phone: (406) 327-0269
Fax: (406) 327-0264
Organisation at this address: Missoula Osteopathic Clinic, Llc
Missoula Osteopathic Clinic, Pllc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 207Q00000X
207Q00000X
Licence states on file: MT
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Montana