KESHAWN LATRELL WALLACE

TULSA, OK
NPI1194532911
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-12-16
Last Update Date2024-12-16
Business Address
KESHAWN LATRELL WALLACE
1111 W 17TH ST
TULSA, OK 74107-1886
Phone number: 918-582-1972
Mailing Address
KESHAWN LATRELL WALLACE
1933 S INDEPENDENCE ST
SAPULPA, OK 74066-6201
Phone number: 903-495-9683