Summer Star Wallace

NPI #1629956396 in Stout, Ohio

Provider Information

NPI Number
1629956396
Entity Type
Individual
Name
Summer Star Wallace
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Technician - Personal Care Attendant
Enumeration Date
Aug 21, 2025
Last Updated
Aug 21, 2025

Practice Location

Address
544 W FORK RD
City
Stout
State
Ohio
ZIP Code
45684-9654
Phone
(937) 421-5881

Specialties & Taxonomy Codes

Specialty
Technician - Personal Care AttendantPersonal Care Attendant

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