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1699385708
IAN WALLACE
WEXFORD, PA
NPI
1699385708
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: PA OC016573)
Enumeration Date
2020-08-04
Last Update Date
2020-08-04
Business Address
IAN WALLACE
10475 PERRY HWY STE 106G
WEXFORD, PA 15090-9213
Phone number: 877-407-3422
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Mailing Address
IAN WALLACE
7 CARNEGIE PLZ
CHERRY HILL, NJ 08003-1000
Phone number: 877-407-3422
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