Individual
CONNAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
691 E 400 N STE 210, VINEYARD, UT 84059-7510
(801) 766-4244
Mailing address
4087 W GREAT NECK DR, SOUTH JORDAN, UT 84009-6021
(801) 389-7298
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
UT
Other
Enumeration date
05/18/2024
Last updated
05/18/2024
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