Individual
ANTHONY CHASE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2161 COURTLAND AVE, KETTERING, OH 45420-2150
(423) 342-5226
Mailing address
2161 COURTLAND AVE, KETTERING, OH 45420-2150
(423) 342-5226
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
07/08/2024
Last updated
07/20/2024
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