Organization
WALLACE FOOT AND ANKLE CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRENTON DALE WALLACE DPM (PODIATRIST)
(405) 446-8290
Entity
Organization
Contact information
Practice address
608 NW 9TH ST, SUITE 4210, OKLAHOMA CITY, OK 73102-1068
(405) 446-8290
Mailing address
608 NW 9TH ST, SUITE 4210, OKLAHOMA CITY, OK 73102-1068
(405) 446-8290
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
292
OK
Other
Enumeration date
08/07/2013
Last updated
06/23/2016
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