DEREK WALLACE

EVANSVILLE, IN
NPI1083925283
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06001705A)
Enumeration Date2010-06-23
Last Update Date2010-06-23
Business Address
-- DEREK WALLACE
150 N ROSENBERGER AVE
EVANSVILLE, IN 47712-6503
Phone number: 812-491-3856
Mailing Address
-- DEREK WALLACE
150 N ROSENBERGER AVE
EVANSVILLE, IN 47712-6503
Phone number:
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