Individual
ADRIENNE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
620 TURNEY RD, 326, BEDFORD, OH 44146-3375
(216) 510-5706
Mailing address
620 TURNEY RD, 326, BEDFORD, OH 44146-3375
(216) 510-5706
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
124931
OH
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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