Individual
MERCEDES WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18821 KEYSTONE ST, DETROIT, MI 48234-2332
(313) 681-3944
Mailing address
46040 LAKE VILLA DR APT 202, BELLEVILLE, MI 48111-3108
(313) 681-3944
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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