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John Wallace, PA-C
NPI 1487909511 · on the registry since 2012
Practice
- Address
- 601 Bridge St
East Jordan, MI 49727 - Phone
- (231) 536-2206
- Fax
- (231) 536-7150
- Organisation at this address
- East Jordan Family Health Center
East Jordan Family Health Center
Laboratory Corporation Of America
Detroit Bio Medical Laboratories,Inc
East Jordan Family Health Center, IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 19
Additional practice sites
- 6135 Cressy St, Indian River, MI
Registry record
- Primary taxonomy
- Physician Assistant
363A00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-09-20
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 Michigan