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General NPI Number Information
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NPI Number | 1194606095
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Entity Type | Organization
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Legal Business Name | LDMAX HEALTH PLLC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 105 W MICHIGAN AVE STE D
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City | BATTLE CREEK
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State | MI
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Zip | 49015
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Country | US
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Telephone | 231-739-9315
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Fax | 269-969-1989
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Provider Business Mailing Address
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Address Line | 93 SUNNYSIDE DR
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City | BATTLE CREEK
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State | MI
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Zip | 49015-3154
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Country | US
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Telephone | 517-256-8298
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAMONA M WALLACE
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Credential | DO, IFMCP
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Telephone | 517-256-8298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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