KELLY WALLACE

CHOCTAW, OK
NPI1184696023
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: OK  PT2460)
Enumeration Date2006-02-05
Last Update Date2015-04-27
Business Address
-- KELLY WALLACE RPT
13390 NE 23RD ST
CHOCTAW, OK 73020-8622
Phone number: 405-769-5555
Mailing Address
-- KELLY WALLACE RPT
13390 NE 23RD ST
CHOCTAW, OK 73020-8622
Phone number: 405-769-5555