MICHELL WALLACE

TRUMBULL, CT
NPI1043554413
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CT  000988)
Enumeration Date2012-11-24
Last Update Date2012-11-24
Business Address
MICHELL WALLACE PTA
6448 MAIN ST
TRUMBULL, CT 06611-2075
Phone number: 203-268-6204
Mailing Address
MICHELL WALLACE PTA
2810 OLD TOWN RD
BRIDGEPORT, CT 06606-1243
Phone number: 203-502-1502
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