MISTY WALLACE

IDAHO FALLS, ID
NPI1881564714
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2025-11-06
Last Update Date2025-11-06
Business Address
MISTY WALLACE
855 N CAPITAL AVE STE 1
IDAHO FALLS, ID 83402-3405
Phone number: 208-552-0855
Mailing Address
MISTY WALLACE
855 N CAPITAL AVE STE 1
IDAHO FALLS, ID 83402-3405
Phone number: 208-552-0855
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