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1598791485
MICHELLE WALLACE
WICHITA, KS
NPI
1598791485
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: KS 15-01052)
Enumeration Date
2006-06-23
Last Update Date
2007-07-08
Business Address
MICHELLE WALLACE PA
550 N HILLSIDE ST
WICHITA, KS 67214-4910
Phone number: 316-962-2239
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Mailing Address
MICHELLE WALLACE PA
PO BOX 548
WICHITA, KS 67201-0548
Phone number: 316-962-2239
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