Tracy Wallace is an administrator registered nurse in Detroit, MI. Tracy Wallace NPI is 1326481755. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
15400 W MCNICHOLS RD
DETROIT, MI
ZIP 48235-724
Phone: (313) 732-8272
The enumeration date for this NPI number is 4/16/2013 and was last updated on 4/16/2013.