David Keith Wallis
NPI #1134685167 in Madison Heights, Michigan
Provider Information
- NPI Number
- 1134685167
- Entity Type
- Individual
- Name
- David Keith Wallis
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Peer Specialist
- Enumeration Date
- Feb 14, 2019
- Last Updated
- Feb 14, 2019
Practice Location
- Address
- 1400 E 12 MILE RD
- City
- Madison Heights
- State
- Michigan
- ZIP Code
- 48071-2651
- Phone
- (248) 658-1116
Specialties & Taxonomy Codes
| Specialty |
|---|
| Peer Specialist |
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