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1568866788
STACIE L WALLACE
BRADENTON, FL
NPI
1568866788
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: FL OT16654)
Enumeration Date
2014-10-17
Last Update Date
2014-10-17
Business 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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Mailing Address
-- STACIE L WALLACE MS, OTR/L
3823 E STATE ROAD 64
BRADENTON, FL 34208-9041
Phone number: 941-745-5111
Copy
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