LODICA WALLACE

COMMERCE TWP, MI
NPI1114587557
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MI  2018023394)
Enumeration Date2019-06-18
Last Update Date2019-06-18
Business Address
LODICA WALLACE
790 DRAKESHIRE DR
COMMERCE TWP, MI 48390-2981
Phone number: 248-910-2762
Mailing Address
LODICA WALLACE
790 DRAKESHIRE DR
COMMERCE TWP, MI 48390-2981
Phone number:
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