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1972125078
MIA WALLACE
INDIANAPOLIS, IN
NPI
1972125078
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
Enumeration Date
2020-05-12
Last Update Date
2020-05-12
Business Address
MIA WALLACE
9165 OTIS AVE STE 232
INDIANAPOLIS, IN 46216-2317
Phone number: 317-560-8522
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Mailing Address
MIA WALLACE
9165 OTIS AVE STE 232
INDIANAPOLIS, IN 46216-2317
Phone number: 317-560-8522
Copy
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