Individual
MARC A WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
138 PLATT DR, JOHNSTOWN, PA 15904-4305
(412) 478-6416
(412) 387-5010
Mailing address
138 PLATT DR, JOHNSTOWN, PA 15904-4305
(412) 478-6416
(412) 387-5010
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS00848L
PA
Other
Enumeration date
07/19/2005
Last updated
09/05/2025
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