CASEY STEPHEN WALLACE

NEWPORT BEACH, CA
NPI1326550518
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
Enumeration Date2017-10-29
Last Update Date2017-10-29
Business Address
CASEY STEPHEN WALLACE DPT
200 NEWPORT CENTER DR STE 213
NEWPORT BEACH, CA 92660-7503
Phone number: 949-644-1322
Mailing Address
CASEY STEPHEN WALLACE DPT
30059 BIG RANGE RD
CANYON LAKE, CA 92587-7660
Phone number: 951-809-6892
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