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1164153409
GAYLE ANN WALLACE
STERLING HEIGHTS, MI
NPI
1164153409
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MI 5502001041)
Enumeration Date
2022-06-17
Last Update Date
2022-06-17
Business Address
GAYLE ANN WALLACE PTA
40778 RAINIER DR
STERLING HEIGHTS, MI 48313-5367
Phone number: 586-819-6887
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Mailing Address
GAYLE ANN WALLACE PTA
40778 RAINIER DR
STERLING HEIGHTS, MI 48313-5367
Phone number: 586-819-6887
Copy
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