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1043951957
STACEY WALLACE
MIDLAND, MI
NPI
1043951957
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MI 5201011236)
Enumeration Date
2022-04-05
Last Update Date
2022-04-05
Business Address
STACEY WALLACE OTRL
5600 WALDO AVE
MIDLAND, MI 48642-6438
Phone number: 989-575-3255
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Mailing Address
STACEY WALLACE OTRL
3326 BINSCARTH AVE
SAGINAW, MI 48602-3203
Phone number: 989-327-9967
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