Wallis, David Keith

Wallis, David Keith is an individual health care provider with primary practice located at 1400 E 12 Mile Rd , Madison Heights MI 48071-2651. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Wallis, David Keith can be contacted via phone (248) 658-1116.

Contact Information

Primary practice address
1400 E 12 Mile Rd Madison Heights MI 48071-2651
Phone: (248) 658-1116
Fax: (248) 658-1120
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X Michigan

Profile Details

NPI number 1134685167
LBN Legal business name Wallis, David Keith
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2019
Last updated Feb 14th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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