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1649865692
MARY ELISE WALLER
SOUTHLAKE, TX
NPI
1649865692
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: TX 1342742)
Enumeration Date
2021-03-02
Last Update Date
2021-03-02
Business Address
MARY ELISE WALLER PT, DPT
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092-1506
Phone number: 469-535-6842
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Mailing Address
MARY ELISE WALLER PT, DPT
5828 COLHURST ST
DALLAS, TX 75230-5020
Phone number: 214-926-6041
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