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1194407668
SERENA A WALLACE
SAN BERNARDINO, CA
NPI
1194407668
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: WA PT61456638)
Enumeration Date
2023-08-03
Last Update Date
2024-08-19
Business Address
SERENA A WALLACE DPT
275 W HOSPITALITY LN STE 100
SAN BERNARDINO, CA 92408-3238
Phone number: 909-567-2221
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Mailing Address
SERENA A WALLACE DPT
206 W OLIVE AVE APT 3
REDLANDS, CA 92373-8810
Phone number: 206-412-8460
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