SearchMichigan235Z00000X

Lionel Wallace

NPI 1053803312 · on the registry since 2018 · sole proprietor

Practice

Address
5577 Whittaker Rd
Ypsilanti, MI 48197
Phone
(734) 395-9282

Registry record

Primary taxonomy
235Z00000X
235Z00000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-06-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan