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1235682238
JAKE TYLER WALLIS
CONWAY, AR
NPI
1235682238
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Professional Name
JAKE TYLER WALLIS
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2016-07-27
Last Update Date
2016-07-27
Business Address
-- JAKE TYLER WALLIS
1630 ARDEN LN
CONWAY, AR 72034-3543
Phone number: 501-477-2202
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Mailing Address
-- JAKE TYLER WALLIS
1630 ARDEN LN
CONWAY, AR 72034-3543
Phone number: 501-477-2202
Copy
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