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1578097341
AMANDA WALLACE
LAFAYETTE, LA
NPI
1578097341
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: LA 08545)
Enumeration Date
2017-04-18
Last Update Date
2017-04-18
Business Address
AMANDA WALLACE DPT
2115 DULLES DR
LAFAYETTE, LA 70506-2652
Phone number: 337-981-9182
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Mailing Address
AMANDA WALLACE DPT
106 STABLE CREEK DR
LAFAYETTE, LA 70506-5021
Phone number:
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