Individual
DAVID WALLENHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS
Contact information
Practice address
40722 STATE ROUTE 154, LISBON, OH 44432-8500
(330) 424-9573
(330) 424-0877
Mailing address
PO BOX 429, LISBON, OH 44432-0429
(330) 424-9573
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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