| Amy Blaising Wallace, D.o. Plc | |
|
818 W King St Ste 103 Owosso MI 48867-2116 | |
| (989) 723-8333 | |
| Not Available |
| Full Name | Amy Blaising Wallace, D.o. Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 818 W King St, Owosso, Michigan |
| Authorized Official Name and Position | Amy Blaising Wallace (OWNER) |
| Authorized Official Contact | 9897238333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Blaising Wallace, D.o. Plc 818 W King St Ste 103 Owosso MI 48867-2116 Ph: () - | Amy Blaising Wallace, D.o. Plc 818 W King St Ste 103 Owosso MI 48867-2116 Ph: (989) 723-8333 |
| NPI Number | 1619171519 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 10/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619171519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101013086 (Michigan) | Primary |
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