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1144065103
MICHAEL WALLACE
STUART, FL
NPI
1144065103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-07-01
Last Update Date
2024-07-01
Business Address
MICHAEL WALLACE
7108 S KANNER HWY
STUART, FL 34997-7462
Phone number: 855-832-6727
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Mailing Address
MICHAEL WALLACE
7108 S KANNER HWY
STUART, FL 34997-7462
Phone number: 855-832-6727
Copy
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