SEAN WALLACE

TUBA CITY, AZ
NPI1114321650
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy376K00000X Nurse's Aide
(Licence: AZ  CNA1000037427)
Enumeration Date2014-10-13
Last Update Date2014-10-13
Business Address
-- SEAN WALLACE
167 NORTH MAIN STREET
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2501
Mailing Address
-- SEAN WALLACE
PO BOX 600 PFS BUSINESS OFFICE
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2781
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