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1497213789
ASHA LEE WALLACE
BOLINGBROOK, IL
NPI
1497213789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-03-06
Last Update Date
2019-03-06
Business Address
ASHA LEE WALLACE
9 FIRETHORN CT
BOLINGBROOK, IL 60490-2003
Phone number: 630-923-9516
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Mailing Address
ASHA LEE WALLACE
9 FIRETHORN CT
BOLINGBROOK, IL 60490-2003
Phone number: 630-923-9516
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