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1659912756
FALLON WALLACE
HAYWARD, CA
NPI
1659912756
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: CA OTA4830)
Enumeration Date
2019-10-01
Last Update Date
2019-10-01
Business Address
FALLON WALLACE COTA
22822 MYRTLE ST
HAYWARD, CA 94541-6321
Phone number: 510-537-4844
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Mailing Address
FALLON WALLACE COTA
342 LYNDA LN
LEXINGTON, NC 27295-7948
Phone number: 336-239-1465
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