BONNIE MERRITT WALLACE

PORTAGE, MI
NPI1437402229
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601006513)
Enumeration Date2012-10-18
Last Update Date2014-10-12
Business Address
Ms. BONNIE MERRITT WALLACE PA-C
3304 COOLEY CT
PORTAGE, MI 49024-7430
Phone number: 269-349-2266
Mailing Address
Ms. BONNIE MERRITT WALLACE PA-C
3304 COOLEY CT
PORTAGE, MI 49024-7430
Phone number: 269-349-2266
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