Search › Ohio › 374U00000X
Keivunia Wallace
NPI 1962169540 · on the registry since 2021 · sole proprietor
Practice
- Address
- 201 Neil St
Niles, OH 44446 - Phone
- (330) 777-9287
Registry record
- Primary taxonomy
- 374U00000X
374U00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-07-04
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 Ohio