Individual
LINDSAY NICOLE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5408 MORNING GLORY ST, SOUTH BLOOMFIELD, OH 43103-3518
(276) 739-8755
Mailing address
5408 MORNING GLORY ST, SOUTH BLOOMFIELD, OH 43103-3518
(276) 739-8755
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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