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1548658149
EARNEST WALLACE
BLUE ISLAND, IL
NPI
1548658149
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2015-01-05
Last Update Date
2015-01-05
Business Address
EARNEST WALLACE
13136 WESTERN AVE
BLUE ISLAND, IL 60406-2423
Phone number: 708-974-5815
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Mailing Address
EARNEST WALLACE
13136 WESTERN AVE
BLUE ISLAND, IL 60406-2423
Phone number: 708-974-5815
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