MICHAEL WALLACE

FOUNTAIN INN, SC
NPI1558139428
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy253Z00000X In Home Supportive Care
(Licence: SC  IHCP-2020)
Enumeration Date2023-12-19
Last Update Date2023-12-19
Business Address
MICHAEL WALLACE
1314 N MAIN ST
FOUNTAIN INN, SC 29644-1332
Phone number: 864-688-2018
Mailing Address
MICHAEL WALLACE
1215 NE MAIN ST STE B
SIMPSONVILLE, SC 29681-6019
Phone number: 864-688-2018
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