M Wallace
NPI #1629359146 in Florissant, Missouri
Provider Information
- NPI Number
- 1629359146
- Entity Type
- Individual
- Name
- M Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Home Health Aide
- Enumeration Date
- Aug 30, 2011
- Last Updated
- Aug 22, 2013
Practice Location
- Address
- 394 SAINT FERDINAND ST
- City
- Florissant
- State
- Missouri
- ZIP Code
- 63031-5918
- Phone
- (314) 831-6300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health Aide |
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