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1578178844
ANDRE LAMAR WALLACE
PHILADELPHIA, PA
NPI
1578178844
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: PA MSG007581)
Enumeration Date
2020-09-13
Last Update Date
2020-09-13
Business Address
-- ANDRE LAMAR WALLACE
435 W ROOSEVELT BLVD APT 2
PHILADELPHIA, PA 19120-4148
Phone number: 215-435-5560
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Mailing Address
-- ANDRE LAMAR WALLACE
435 W ROOSEVELT BLVD APT 2
PHILADELPHIA, PA 19120-4148
Phone number: 215-435-5560
Copy
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