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1265115554
PAYTON A WALLACE
FAYETTEVILLE, AR
NPI
1265115554
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-08-11
Last Update Date
2023-08-11
Business Address
PAYTON A WALLACE
60 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703-1822
Phone number: 479-695-1240
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Mailing Address
PAYTON A WALLACE
60 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703-1822
Phone number: 479-695-1240
Copy
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