Search › Minnesota › 103T00000X
Randall Wallace, M.S
NPI 1689768707 · on the registry since 2006
Practice
- Address
- 133 2nd Ave Sw
Cambridge, MN 55008 - Phone
- (763) 689-9407
- Fax
- (763) 552-0164
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Licence states on file
- MN
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 Minnesota