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1104883099
JILL WALLACE
WAUKESHA, WI
NPI
1104883099
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 10232)
Enumeration Date
2006-04-26
Last Update Date
2012-01-18
Business Address
-- JILL WALLACE PT
W239N1812 ROCKWOOD DR STE 100 PHCMA INC.
WAUKESHA, WI 53188-1113
Phone number: 262-523-0310
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Mailing Address
-- JILL WALLACE PT
W239N1812 ROCKWOOD DR STE 100 PHCMA INC.
WAUKESHA, WI 53188-1113
Phone number: 262-523-0310
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