Michelle Wallace
NPI #1770051252 in Fort Gibson, Oklahoma
Provider Information
- NPI Number
- 1770051252
- Entity Type
- Individual
- Name
- Michelle Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Technician - Personal Care Attendant
- Enumeration Date
- Nov 2, 2018
- Last Updated
- Nov 2, 2018
Practice Location
- Address
- 1515 SUMAC RD
- City
- Fort Gibson
- State
- Oklahoma
- ZIP Code
- 74434-7512
- Phone
- (918) 616-5408
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician - Personal Care Attendant — Personal Care Attendant |
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