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1376079558
ELISE LA KEISHA WALLACE
COMPTON, CA
NPI
1376079558
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2017-05-05
Last Update Date
2017-05-05
Business Address
Miss ELISE LA KEISHA WALLACE 172v00000x
921 E COMPTON BLVD
COMPTON, CA 90221-3303
Phone number: 310-668-6947
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Mailing Address
Miss ELISE LA KEISHA WALLACE 172v00000x
921 E COMPTON BLVD
COMPTON, CA 90221-3303
Phone number: 310-668-6947
Copy
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