Individual provider · Type 1 NPI

De'juan Lamar Wallace

Rehabilitation Practitioner · Las Vegas, NV

NPI number 1487043139 Active

Practice location

6889 S Eastern Ave
Las Vegas, NV 89119-4687

Call (702) 802-4900 Map

Mailing address

4130 N Mlk Blvd
North Las Vegas, NV 89032-0299

Specialties and licenses

TaxonomyCodeLicense
Rehabilitation Practitioner Primary 225400000XNone listed

Rehabilitation Practitioner: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

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About NPI 1487043139

De'juan Lamar Wallace's National Provider Identifier is 1487043139, issued on Jan 20, 2015. The primary taxonomy on file is Rehabilitation Practitioner (225400000X), and the practice location is in Las Vegas, NV. The record was last updated on Jan 20, 2015.