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1568420354
RYAN JAMES WALLACE
BONITA SPRINGS, FL
NPI
1568420354
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PT 18604)
Enumeration Date
2006-05-02
Last Update Date
2015-05-12
Business Address
-- RYAN JAMES WALLACE PT, DPT, OCS, MTC
25241 ELEMENTARY WAY STE 200
BONITA SPRINGS, FL 34135-7883
Phone number: 239-947-4184
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Mailing Address
-- RYAN JAMES WALLACE PT, DPT, OCS, MTC
8079 BRETON CIR
FORT MYERS, FL 33912-4651
Phone number: 239-947-4184
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