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1144078239
KENNETH WALTER WALLACE
CLEVELAND, OH
NPI
1144078239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-05-13
Last Update Date
2024-05-13
Business Address
Mr. KENNETH WALTER WALLACE
11075 EAST BLVD
CLEVELAND, OH 44106-5409
Phone number: 216-368-2766
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Mailing Address
Mr. KENNETH WALTER WALLACE
2300 OVERLOOK RD APT 110
CLEVELAND HEIGHTS, OH 44106-2346
Phone number: 717-572-5619
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