Penny Sue Wallace

NPI #1518510122 in Defiance, Ohio

Provider Information

NPI Number
1518510122
Entity Type
Individual
Name
Penny Sue Wallace
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Community Health Worker
Enumeration Date
Jul 23, 2019
Last Updated
Jul 23, 2019

Practice Location

Address
6825 N STATE ROUTE 66
State
Ohio
ZIP Code
43512-6730
Phone
(419) 782-4196

Specialties & Taxonomy Codes

Specialty
Community Health Worker

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