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1356027999
COREY WALLACE
CANTON, OH
NPI
1356027999
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child
Enumeration Date
2023-06-27
Last Update Date
2023-06-27
Business Address
Mr. COREY WALLACE
2460 25TH ST NE
CANTON, OH 44705-2468
Phone number: 330-704-0134
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Mailing Address
Mr. COREY WALLACE
2460 25TH ST NE
CANTON, OH 44705-2468
Phone number: 330-704-0134
Copy
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