GARY ROBERT WALLACE

JACKSON, MS
NPI1003009184
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: LA  A2636)
Enumeration Date2007-08-22
Last Update Date2007-08-22
Business Address
-- GARY ROBERT WALLACE PTA
13 NORTHTOWN DR TRINITY REHAB SUITE 110
JACKSON, MS 39211
Phone number: 601-206-9195
Mailing Address
-- GARY ROBERT WALLACE PTA
13 NORTHTOWN DR SUITE 110 TRINITY REHAB
JACKSON, MS 39211
Phone number: 601-206-9195
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