BEVERLY WALLACE

BRADENTON, FL
NPI1174595367
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: FL  OT9730)
Enumeration Date2006-02-02
Last Update Date2007-07-09
Business Address
Mrs. BEVERLY WALLACE OTR/L
3911 GOLF PARK LOOP SUITE #105
BRADENTON, FL 34203-3453
Phone number: 941-756-1003
Mailing Address
Mrs. BEVERLY WALLACE OTR/L
6477 INDIGO BUNTING PL
BRADENTON, FL 34202-8246
Phone number: 941-756-1003
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