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1689398141
MARY WALLACE
SAINT CHARLES, MO
NPI
1689398141
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MO 2022037104)
Enumeration Date
2022-09-28
Last Update Date
2023-04-14
Business Address
MARY WALLACE OTR
2150 W RANDOLPH ST
SAINT CHARLES, MO 63301-0844
Phone number: 636-946-4966
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Mailing Address
MARY WALLACE OTR
7527 TEASDALE AVE
SAINT LOUIS, MO 63130-3923
Phone number:
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