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1548444318
PAUL S WALLACE
BARTLESVILLE, OK
NPI
1548444318
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OK L0050977)
Enumeration Date
2007-12-28
Last Update Date
2007-12-28
Business Address
-- PAUL S WALLACE
513 SE QUAPAW
BARTLESVILLE, OK 74003
Phone number: 918-337-8080
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Mailing Address
-- PAUL S WALLACE
1400 S HIGH STREET
CANEY, KS 67333
Phone number: 918-337-8080
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