Organization
WALLACE CCSD 195
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAVID MATTESON ED.S. (SUPERINTENDENT)
(815) 433-2986
Entity
Organization
Contact information
Practice address
1463 N 33RD RD, OTTAWA, IL 61350-9622
(815) 433-2986
(815) 433-2322
Mailing address
1463 N 33RD RD, OTTAWA, IL 61350-9622
(815) 433-2986
(815) 433-2322
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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