Organization
D WALLACE HEALTH PROMOTION AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIONNE LANETTE WALLACE MSN RN CNL (FOUNDER/CHIEF ADMINISTATOR)
(586) 241-7088
Entity
Organization
Contact information
Practice address
15730 MOK AVE, EASTPOINTE, MI 48021-2367
(313) 415-1538
(586) 585-9555
Mailing address
15730 MOK AVE, EASTPOINTE, MI 48021-2367
(313) 415-1538
(586) 585-9555
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
4704260135
MI
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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