MARYKELLY WALLACE

DETROIT, MI
NPI1598372187
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: MI  5201010849)
Enumeration Date2020-09-28
Last Update Date2020-09-28
Business Address
MARYKELLY WALLACE MOTR/L
7800 W OUTER DR STE 300
DETROIT, MI 48235-3458
Phone number: 586-204-5560
Mailing Address
MARYKELLY WALLACE MOTR/L
27085 GRATIOT AVE STE 101
ROSEVILLE, MI 48066-2984
Phone number:
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