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1740610005
JOHNNA WALLACE
OKLAHOMA CITY, OK
NPI
1740610005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
231H00000X Audiologist
(Licence: OK 4140)
Enumeration Date
2013-11-22
Last Update Date
2019-05-29
Business Address
JOHNNA WALLACE AUD
11500 N PORTLAND AVE
OKLAHOMA CITY, OK 73120
Phone number: 405-548-4300
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Mailing Address
JOHNNA WALLACE AUD
11500 N PORTLAND AVE
OKLAHOMA CITY, OK 73120-4625
Phone number: 405-548-4300
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