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1568830719
COLLIN WILLIAM WALLACE
CLEARWATER, FL
NPI
1568830719
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL 30787)
Enumeration Date
2015-09-04
Last Update Date
2016-11-18
Business Address
-- COLLIN WILLIAM WALLACE DPT
2349 SUNSET POINT RD STE 400
CLEARWATER, FL 33765-1439
Phone number: 970-371-8965
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Mailing Address
-- COLLIN WILLIAM WALLACE DPT
3903 NORTHDALE BLVD STE 111W
TAMPA, FL 33624-1853
Phone number: 813-805-8167
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