LAWANDA WALLACE

CHICAGO, IL
NPI1154788875
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy347C00000X Private Vehicle
(Licence: IL  w42053371706)
Enumeration Date2016-01-26
Last Update Date2016-01-26
Business Address
-- LAWANDA WALLACE
11559 S OAKLEY AVE
CHICAGO, IL 60643-4721
Phone number: 773-391-6689
Mailing Address
-- LAWANDA WALLACE
11559 S OAKLEY AVE
CHICAGO, IL 60643-4721
Phone number: 773-391-6689