Individual
MRS. ANTIA LYNN MARSHALL-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
258 PASADENA AVE, YOUNGSTOWN, OH 44507-1527
(330) 951-3876
Mailing address
258 PASADENA AVE, YOUNGSTOWN, OH 44507-1527
(330) 951-3876
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401777960815
OH
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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