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1770011124
IAN WALLACE
SHERIDAN, WY
NPI
1770011124
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-05-30
Last Update Date
2017-06-27
Business Address
IAN WALLACE
151 W BRUNDAGE ST
SHERIDAN, WY 82801-4217
Phone number: 307-674-1668
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Mailing Address
IAN WALLACE
151 W BRUNDAGE ST
SHERIDAN, WY 82801-4217
Phone number:
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