SUSAN JEAN WALLACE

PINE RIDGE, SD
NPI1194985887
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: NE  26784)
Enumeration Date2008-06-16
Last Update Date2008-06-16
Business Address
-- SUSAN JEAN WALLACE
E HWY 18
PINE RIDGE, SD 57770-1201
Phone number: 605-867-5131
Mailing Address
-- SUSAN JEAN WALLACE
E HWY 18
PINE RIDGE, SD 57770-1201
Phone number:
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