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1528589629
DANIELLE WALLACE
MACON, GA
NPI
1528589629
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: GA OT005020)
Enumeration Date
2017-06-29
Last Update Date
2017-06-29
Business Address
DANIELLE WALLACE
5021 MERCER UNIVERSITY DR
MACON, GA 31210-5691
Phone number: 478-845-3520
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Mailing Address
DANIELLE WALLACE
PO BOX 1552
BYRON, GA 31008-1552
Phone number: 478-845-3520
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