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Dr. Gregory Wallis, DO
Student in an Organized Health Care Education/Training Program in Joplin, Missouri
NPI 1790308278

Gregory Wallis is a Student in an Organized Health Care Education/Training Program based in Joplin, MO. Gregory Wallis practices in Joplin, MO and has the professional credentials of DO. The NPI Number for Gregory Wallis is 1790308278 and holds a License No. (Missouri).

The current practice location address for Gregory Wallis is 1031 Mcintosh Cir, Joplin, MO and can be reached out via phone at 801-455-5078 and via fax at 437-537-5094.

Location: 1031 Mcintosh Cir, Joplin, MO, 64804-3643
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790308278
Provider Name
Gregory Wallis
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1031 Mcintosh Cir, Joplin, MO, 64804-3643
Phone Number
801-455-5078
Fax Number
437-537-5094
Provider Enumeration Date
05/19/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1031 Mcintosh Cir
City
Joplin
State
Missouri
Zip
64804-3643
Phone Number
801-455-5078
Fax Number
437-537-5094
person
Provider Business Mailing Address Details
Address
1031 Mcintosh Cir
City
Joplin
State
Missouri
Zip
64804-3643
Phone Number
801-455-5078
Fax Number
437-537-5094
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Missouri)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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