Individual
DARIS L WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRISIS RES SPEC
Contact information
Practice address
100 WEST AVE, GALLIPOLIS, OH 45631-1674
(740) 446-5554
(740) 446-8988
Mailing address
PO BOX 188, CHILLICOTHE, OH 45601-0188
(740) 773-4366
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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