STACIE L WALLACE

BRADENTON, FL
NPI1568866788
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: FL  OT16654)
Enumeration Date2014-10-17
Last Update Date2014-10-17
Business Address
STACIE L WALLACE MS, OTR/L
3823 E STATE ROAD 64
BRADENTON, FL 34208-9041
Phone number: 941-745-5111
Mailing Address
STACIE L WALLACE MS, OTR/L
3823 E STATE ROAD 64
BRADENTON, FL 34208-9041
Phone number: 941-745-5111
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