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1073902250
GREGORY ROY WALLACE
VAN NUYS, CA
NPI
1073902250
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2015-01-12
Last Update Date
2015-01-12
Business Address
-- GREGORY ROY WALLACE MSW
14545 SHERMAN CIR
VAN NUYS, CA 91405-3087
Phone number: 818-374-6901
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Mailing Address
-- GREGORY ROY WALLACE MSW
14545 SHERMAN CIR
VAN NUYS, CA 91405-3087
Phone number: 818-374-6901
Copy
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