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Individual

CHARA WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3510 PIN OAK DR UNIT B, LORAIN, OH 44052-2680
(440) 783-0292
Mailing address
3510 PIN OAK DR UNIT B, LORAIN, OH 44052-2680
(440) 783-0292

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Enumeration date
01/05/2023
Last updated
01/05/2023
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Product
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