Bodi Grayson Wallace
Bodi Grayson Wallace is a Homemaker in South Bloomfield, Ohio. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
5408 Morning Glory StSouth Bloomfield, OH 43103-3518
Phone: (740) 497-6108
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Homemaker (primary) | Taxonomy 376J00000X |
|---|
Record details
| NPI number | 1609624881 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 11, 2024 |
| Last updated in NPPES | May 11, 2024 |
| Certification date | May 11, 2024 |
| Mailing address | 5408 Morning Glory St, South Bloomfield, OH 43103-3518 |
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