MICHELLE WALLACE

WICHITA, KS
NPI1598791485
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: KS  15-01052)
Enumeration Date2006-06-23
Last Update Date2007-07-08
Business Address
-- MICHELLE WALLACE PA
550 N HILLSIDE ST
WICHITA, KS 67214-4910
Phone number: 316-962-2239
Mailing Address
-- MICHELLE WALLACE PA
PO BOX 548
WICHITA, KS 67201-0548
Phone number: 316-962-2239
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