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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