KACIE WALLACE

DETROIT, MI
NPI1750871455
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  1151843)
Enumeration Date2018-05-17
Last Update Date2019-09-15
Business Address
KACIE WALLACE M.S., PA-C
22101 MOROSS RD
DETROIT, MI 48236-2148
Phone number: 313-343-4000
Mailing Address
KACIE WALLACE M.S., PA-C
226 WIMPOLE DR
ROCHESTER HILLS, MI 48309-2148
Phone number: 248-720-8197
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