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1477020659
BROOKE WALLACE
JONESBORO, AR
NPI
1477020659
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Former Name
BROOKE TURNER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AR OT-A1418)
Enumeration Date
2018-10-25
Last Update Date
2021-05-20
Business Address
BROOKE WALLACE COTA/L
1699 RED WOLF BLVD
JONESBORO, AR 72401-5442
Phone number: 870-336-0021
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Mailing Address
BROOKE WALLACE COTA/L
313 NATCHEZ DR
JONESBORO, AR 72404-9104
Phone number: 870-253-9293
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