| NPI | 1710133475 |
|---|---|
| Other Name | BARBARA J WALLACE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225000000X Orthotic Fitter |
| Additional Taxonomies | 171W00000X Contractor |
| 224L00000X | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2011-03-22 |