All Medicaid billing entities listing WALLACE, SAM (OWNER/PHYSICIAN) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Montana | 1 | $21K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | MISSOULA OSTEOPATHIC CLINIC, LLC | MISSOULA, MT | Family Medicine Physician | $21K |