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1942612551
ERNEST WALLACE
LAWTON, OK
NPI
1942612551
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
Enumeration Date
2014-05-30
Last Update Date
2014-05-30
Business Address
MR. ERNEST WALLACE
1716 NW CACHE RD SUITE B
LAWTON, OK 73507-4551
Phone number: 580-574-8414
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Mailing Address
MR. ERNEST WALLACE
1716 NW CACHE RD SUITE B
LAWTON, OK 73507-4551
Phone number: 580-574-8414
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