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1053818039
LATONYA WALLACE-HARDIMAN
DETROIT, MI
NPI
1053818039
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QP3300X Clinic/Center, Pain
Enumeration Date
2018-04-06
Last Update Date
2020-12-17
Business Address
LATONYA WALLACE-HARDIMAN BA, MSA
5830 CONNER ST
DETROIT, MI 48213-3458
Phone number: 313-924-1456
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Mailing Address
LATONYA WALLACE-HARDIMAN BA, MSA
162 SAND BAR LN
DETROIT, MI 48214-8034
Phone number: 313-715-7170
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