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Individual

DR. TRENTON WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
608 NW 9TH ST, #4210, OKLAHOMA CITY, OK 73102-1068
(405) 446-8290
(405) 601-8298
Mailing address
608 NW 9TH ST, #4210, OKLAHOMA CITY, OK 73102-1068
(405) 446-8290
(405) 601-8298

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
292
OK

Other

Enumeration date
03/10/2009
Last updated
01/20/2016
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