Justice Kassidy Wallace
Justice Kassidy Wallace is a Technician in Salt Lake City, Utah. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
344 E 100 S Ste 301Salt Lake City, UT 84111-1727
Phone: (801) 428-4257
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Technician (primary) | Taxonomy 374700000X |
|---|
Record details
| NPI number | 1467173765 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 6, 2022 |
| Last updated in NPPES | September 6, 2022 |
| Certification date | September 6, 2022 |
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