Search › Michigan › 164W00000X
Lisa Wallace
NPI 1992368872 · on the registry since 2019
Practice
- Address
- 8700 Mosherville Rd
Horton, MI 49246 - Phone
- (517) 358-5830
Registry record
- Primary taxonomy
- 164W00000X
164W00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-12-12
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