Individual
MS. ALICE FAYE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 267-5323
(937) 267-5316
Mailing address
1838 SPEICE AVE, DAYTON, OH 45403-3135
(937) 256-8722
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN136168
OH
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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