Individual
BENJAMIN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5848 S 300 E, MURRAY, UT 84107-6157
(801) 314-4040
Mailing address
PO BOX 25537, SALT LAKE CITY, UT 84125-0537
(801) 314-4040
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13189250-2401
UT
Other
Enumeration date
01/19/2023
Last updated
05/20/2025
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