MARK WALLACE

OKLAHOMA CITY, OK
NPI1093501801
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2025-04-17
Last Update Date2025-04-17
Business Address
MARK WALLACE
1510 NW 18TH ST
OKLAHOMA CITY, OK 73106-4214
Phone number: 845-413-9271
Mailing Address
MARK WALLACE
1510 NW 18TH ST
OKLAHOMA CITY, OK 73106-4214
Phone number: 845-413-9271