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1922840529
RAYVOHN WALLACE
LOS ANGELES, CA
NPI
1922840529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-06-12
Last Update Date
2024-06-12
Business Address
RAYVOHN WALLACE
840 N AVENUE 66
LOS ANGELES, CA 90042-1508
Phone number: 626-395-7100
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Mailing Address
RAYVOHN WALLACE
840 N AVENUE 66
LOS ANGELES, CA 90042-1508
Phone number: 626-395-7100
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