Lodica Wallace
NPI #1114587557 in Commerce Twp, Michigan
Provider Information
- NPI Number
- 1114587557
- Entity Type
- Individual
- Name
- Lodica Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Jun 18, 2019
- Last Updated
- Jun 18, 2019
Practice Location
- Address
- 790 DRAKESHIRE DR
- City
- Commerce Twp
- State
- Michigan
- ZIP Code
- 48390-2981
- Phone
- (248) 910-2762
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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