DAVID KEITH WALLIS

MADISON HEIGHTS, MI
NPI1134685167
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2019-02-14
Last Update Date2019-02-14
Business Address
DAVID KEITH WALLIS
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071-2651
Phone number: 248-658-1116
Mailing Address
DAVID KEITH WALLIS
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071-2651
Phone number: 248-658-1116