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Search › North Dakota › 183500000X

Spencer Wallace

NPI 1841837309 · on the registry since 2019

Practice

Address
1599 J St
Grand Forks Afb, ND 58205
Phone
(701) 747-5382
Organisation at this address
319th Medgrp-Grand Forks
319th Medgrp-Grand Forks
Inferred from a shared address, not stated in the registry.
Clinicians at this address
29

Registry record

Primary taxonomy
183500000X
183500000X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-12-04

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 North Dakota